Active NPI
Pedro A Marcucci, MD
- Urology Physician
- North Fort Myers, FL
National Provider Identifier
1437168929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME86865
- Practice address
- 18900 N Tamiami TRL
Suite A12
North Fort Myers, FL 33903-7312 - Phone
- (239) 458-0168
- Fax
- (239) 458-3925
- NPI assigned
- Aug 5, 2006
- Last updated
- Jun 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME86865 | FL | Primary |
Addresses
Primary practice location
18900 N Tamiami TRL
Suite A12
North Fort Myers, FL 33903-7312
Mailing address
2234 Colonial Blvd
Managed Care Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00445995 | Other | FL | RAILROAD MEDICARE |
| 7016304 | Other | FL | AETNA PROVIDER # |
| 57661 | Other | FL | BCBS OF FLORIDA PROV. # |
| 8892692 | Other | FL | CIGNA PROVIDER # |
Other names 1
- Pedro A Marcucci-Laboy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME86865 | FL | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244419200000",
"number": "1437168929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2234 COLONIAL BLVD",
"address_2": "MANAGED CARE DEPT.",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339071412",
"telephone_number": "239-931-7342",
"fax_number": "239-931-7382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18900 N TAMIAMI TRL",
"address_2": "SUITE A12",
"city": "NORTH FORT MYERS",
"state": "FL",
"postal_code": "339037312",
"telephone_number": "239-458-0168",
"fax_number": "239-458-3925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUCCI",
"first_name": "PEDRO",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2009-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME86865",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00445995",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER #",
"identifier": "7016304",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF FLORIDA PROV. #",
"identifier": "57661",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER #",
"identifier": "8892692",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PEDRO",
"last_name": "MARCUCCI-LABOY",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in North Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.