Active NPI
Juan Carlos Cucalon, M.D.
- Anesthesiology Physician
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- C170661
- Practice address
- 1441 Florida Ave
Modesto, CA 95350-4404 - Phone
- (209) 214-1211
- NPI assigned
- Nov 11, 2005
- Last updated
- Nov 25, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ME86152 | FL | |
| Anesthesiology Physician | 207L00000X | C170661 | CA | Primary |
Addresses
Primary practice location
1441 Florida Ave
Modesto, CA 95350-4404
Mailing address
1441 Florida Ave
Modesto, CA 95350-4404
Phone (209) 214-1211
Other practice location 1
7031 SW 62nd Ave
South Miami, FL 33143-4701
Phone (786) 871-6800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71471 | Other | FL | B/C & B/S OF FL |
| 266805000 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 63.03 of 100
- Quality
- 44.74
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C170661 | CA | MD | Anesthesiology Physician |
| ME86152 | FL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Physician Partners | Current | Accepting new patients | |
| Valley Regional Anesthesia Associates Inc | Anesthesiology | Current | Accepting new patients |
| First Choice Physician Partners | Current | Accepting new patients | |
| First Choice Physician Partners | Current | Accepting new patients |
Locations
3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000
1660 W 3rd St
Los Angeles, CA 90017
Phone (213) 201-0850
1205 E North St
Manteca, CA 95336
Phone (209) 239-8301
145 Trevino Ave
Manteca, CA 95337
Phone (209) 788-8180
1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235
1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839
465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886
2900 Eureka Way
Redding, CA 96001
Phone (530) 225-8700
825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Fresno, CA
- NPI 1578272415
-
dba Greater Modesto Medical Surgical Associates
- Neurological Surgery Physician
- Modesto, CA
- NPI 1104183052
-
- Internal Medicine Physician
- Modesto, CA
- NPI 1912264862
-
dba De La Pena Eye Clinic, A Medical Group
- Ophthalmology Physician
- El Monte, CA
- NPI 1912732892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1649251083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 FLORIDA AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504404",
"telephone_number": "209-214-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 FLORIDA AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504404",
"telephone_number": "209-214-1211"
}
],
"practiceLocations": [
{
"address_1": "7031 SW 62nd Ave",
"address_purpose": "LOCATION",
"city": "South Miami",
"state": "FL",
"postal_code": "331434701",
"country_code": "US",
"telephone_number": "786-871-6800",
"fax_number": "786-871-6801",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CUCALON",
"first_name": "JUAN",
"middle_name": "CARLOS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-11",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME86152",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "C170661",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B/C & B/S OF FL",
"identifier": "71471",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "266805000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.