Samuel J Mucci M.D.P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301067463 Issued in MI

Legal business name

SAMUEL J MUCCI M.D.P.C.

Practice address

15590 W 13 Mile Rd
Suite a
Beverly Hills, MI 48025-5642

Phone

(248) 283-1115

Fax

(248) 283-1119

NPI assigned

Mar 27, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Michele A Barc

Title

Medical Biller

Phone

(248) 283-1115

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel J Mucci, M.D.

  • Specialist
  • Beverly Hills, MI
  • NPI 1073514048
  Medicare reassignment NPD

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1629240965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15590 W 13 MILE RD",
            "address_2": "SUITE A",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255642",
            "telephone_number": "248-283-1115",
            "fax_number": "248-283-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15590 W 13 MILE RD",
            "address_2": "SUITE A",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255642",
            "telephone_number": "248-283-1115",
            "fax_number": "248-283-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL J MUCCI M.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "BARC",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "248-283-1115",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301067463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "2406314511",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103269170",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaber Saad, MD
• Joseph Salama, M.D.
• Sales,Food,&Health Service LLC
• Kelly L Salter, AT
• Rakel K Sami, NP
• Tina Sappington, MA-CCC
• Reza S Sazgari, MD
• Therese Scarpace
• Joanne Karen Schouten I, PH.D.
• Meg Schulte, NP

• Specialist in Beverly Hills, MI
• Providers in Beverly Hills, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.