Individual provider Active NPI

Mauro Moscucci, MD, MBA, MPH

  • Cardiovascular Disease Physician
  • Baltimore, MD
National Provider Identifier
1558447516
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D0078436 Issued in MD
Practice address
960 Fell St Unit 418
Baltimore, MD 21231-3546
Phone
(734) 276-6663
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0078436 MD
Internal Medicine Physician 207R00000X 4301064397 MI
Cardiovascular Disease Physician 207RC0000X 4301064397 MI
Cardiovascular Disease Physician 207RC0000X D0078436 MD Primary

Addresses

Primary practice location

960 Fell St Unit 418
Baltimore, MD 21231-3546

Mailing address

960 Fell St Unit 418
Baltimore, MD 21231-3546
Phone (734) 276-6663

Other identifiers 1

IdentifierTypeStateIssuer
3123238MedicaidMI

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
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0078436MDMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1558447516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 FELL ST UNIT 418",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313546",
            "telephone_number": "734-276-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 FELL ST UNIT 418",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313546",
            "telephone_number": "734-276-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCUCCI",
        "first_name": "MAURO",
        "credential": "MD, MBA, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0078436",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301064397",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301064397",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D0078436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3123238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.