Individual provider Active NPI

Gregory Cuculino, MD

  • Emergency Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1669429130
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME131250 Issued in FL
Practice address
222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone
(386) 310-2160
Fax
(386) 310-2106
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD067278L PA
Emergency Medicine Physician 207P00000X ME131250 FL Primary

Addresses

Primary practice location

222 S Peninsula Dr
Daytona Beach, FL 32118-4422

Mailing address

222 S Peninsula Dr
Daytona Beach, FL 32118-4422
Phone (386) 310-2160

Other identifiers 1

IdentifierTypeStateIssuer
001754621MedicaidPA

Other names 1

  • Gregory P Cuculino Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170808003940 FL Practitioner - Emergency Medicine 7214123280 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME131250FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Emergency Medicine Professionals PA Emergency Medicine CurrentSince Jun 6, 2024 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients
Delmar Emergency Specialists PA Emergency Medicine Past Accepting new patients
Doctors for Emergency Service Emergency Medicine Past Accepting new patients
Main Line Emergency Med Associates LLC Emergency Medicine Past Accepting new patients

Locations

222 S Peninsula Dr
Daytona Beach, FL 32118
Phone (386) 310-2160

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

5028 Okeechobee Blvd
West Palm Beach, FL 33417
Phone (561) 578-6700

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

Organizations & group practices 7

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1669429130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S PENINSULA DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184422",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S PENINSULA DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321184422",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCULINO",
        "first_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD067278L",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME131250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001754621",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "CUCULINO",
            "middle_name": "P",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.