Peter Scuccimarri, M.D.

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

35.146077 Issued in OH

Practice address

1655 Holland Rd Ste F
Maumee, OH 43537-1656

Phone

(833) 510-4357

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797

  Family Medicine

  Medicare reassignment NPD
• Harrington Physician Services Inc

  • Family Medicine Physician
  • Southbridge, MA
  • NPI 1346420874
  NPD (past)
• University Physician Group

  • Counselor
  • Detroit, MI
  • NPI 1447465661
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1568422111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021457",
            "telephone_number": "513-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 HOLLAND RD STE F",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371656",
            "telephone_number": "833-510-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Chrysler Dr Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012167",
            "country_code": "US",
            "telephone_number": "313-993-3964",
            "fax_number": "313-993-3974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCUCCIMARRI",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301047163",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4301047163",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35.146077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0811926",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Albert Schwartz, CRNA
• Traci Schweizer, COTA/L
• Allen G Schwisow, M.D.
• Patricia Eileen Scott, RDN, LD
• Shannon Scott, RBT
• Liliana Sedlock, RBT
• Sara Seiler, MA, CCC-SLP
• Shawnte Self
• Jessica Sells
• Senior Care Physicians, Inc.

• Addiction Medicine (Internal Medicine) Physician in Maumee, OH
• Providers in Maumee, OH by specialty
• Addiction Medicine (Internal Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.