Mario Pucci, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13521403-1205 Issued in UT

Practice address

375 S Chipeta Way RM 201
Salt Lake City, UT 84108-1260

Phone

(801) 581-2121

NPI assigned

Apr 6, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moab Regional Hospital Hospital, Moab, UT, CCN 461302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mario.pucci.1@13794.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moab Valley Healthcare, Inc

  • Critical Access Hospital
  • Moab, UT
  • NPI 1770513236
  Medicare reassignment
• Moab Valley Healthcare, Inc.

  • Community/Retail Pharmacy
  • Moab, UT
  • NPI 1235918962
  NPD
• Moab Valley Healthcare, Inc.

  • Methadone Clinic
  • Moab, UT
  • NPI 1285380394
  NPD
• Moab Valley Healthcare Inc

  • Certified Registered Nurse Anesthetist
  • Moab, UT
  • NPI 1700857398
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Moab Valley Healthcare, Inc

  • Critical Access Hospital
  • Moab, UT
  • NPI 1770513236
  Care Compare affiliation
• Moab Valley Healthcare, Inc.

  • Methadone Clinic
  • Moab, UT
  • NPI 1285380394

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1497496087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY RM 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081260",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY RM 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081260",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 S Main St",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "UT",
            "postal_code": "840141817",
            "country_code": "US",
            "telephone_number": "801-693-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCCI",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "13521403-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psychiatry Consulting & Research, LLC
• Psychological Solutions, Inc
• Psychsolutions PC
• Elenoa Tuitavuki Pua
• Luseane Kolokitonga Puamau
• Evan Michael Pucillo, PT, DPT
• Julia Puckett, CSW
• Megan Puckett, MD
• Donnalesa Janet Puente
• Shauna Pufahl

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.