Individual provider Active NPI

Juan Carlos Cucalon, M.D.

  • Anesthesiology Physician
  • Modesto, CA
National Provider Identifier
1649251083
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
C170661 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4404
Phone
(209) 214-1211
NPI assigned
Nov 11, 2005
Last updated
Nov 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
71471OtherFLB/C & B/S OF FL
266805000MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210105003178 CA Practitioner - Anesthesiology 2466632823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
63.03 of 100Reported as group
Quality
44.74
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C170661CAMDAnesthesiology Physician
ME86152FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners Current Accepting new patients
Valley Regional Anesthesia Associates Inc Anesthesiology CurrentSince Dec 6, 2023 Accepting new patients
First Choice Physician Partners CurrentSince Dec 1, 2020 Accepting new patients
First Choice Physician Partners CurrentSince Dec 1, 2020 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.

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

Verify at the official NPI Registry.