Mario Andrew Pucci, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9105599 Issued in FL

Practice address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Phone

(703) 664-5000

Fax

(703) 663-5067

NPI assigned

Jul 6, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Orthopaedic Consultants of Cincinnati, Inc.

  • Orthopaedic Surgery Physician
  • Cincinnati, OH
  • NPI 1396792529
  NPD (past)

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1699087890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E SHORES BLVD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638966",
            "telephone_number": "703-624-6293",
            "fax_number": "703-664-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "703-664-5000",
            "fax_number": "703-663-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCI",
        "first_name": "MARIO",
        "middle_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie E Pollard, MPAS, PA/C
• Chae-Im Santos Pontius, M.D.
• Lauren Elizabeth Potts, M.D.
• John Michael Powers, M.D.
• Rhonda Marie Pridgeon, M.D.
• Diana D Puffenbarger, RPH
• Larissa Ann Quinn, DO
• Katherine Elizabeth Quraishi-Knobloch, DO
• Alexander K Rahimi, M.D.
• Ashok Ramalingam, RPH, PHD

• Medical Physician Assistant in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.