NPIMap

Individual provider Active NPI

Daniel Ian Pascucci, M.D.

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1801089073
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25795 Issued in OK
Practice address
4200 W Memorial Rd
Oklahoma City, OK 73120-9350
Phone
(405) 752-3962
Fax
(405) 752-3963
NPI assigned
Aug 21, 2007
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25795 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd
Oklahoma City, OK 73120-9350

Mailing address

4200 W Memorial Rd
Oklahoma City, OK 73120-9350
Phone (405) 752-3962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140903001600 OK Practitioner - Internal Medicine 2163654732 Reassigns benefits to 12 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital Kingfisher, IncGroup PAC ID 5395970180, 10 clinicians
Mercy Hospital Logan County, IncGroup PAC ID 4587836200, 25 clinicians

Practice addresses (Care Compare)

1000 Hospital Dr
Kingfisher, OK 73750-5029
Phone (405) 375-3141

200 S Academy Rd
Guthrie, OK 73044-8727
Phone (405) 282-6700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Kingfisher, Inc CurrentSince Jan 1, 2019 Accepting new patients
Mercy Hospital Logan County Inc CurrentSince Jun 1, 2020 Accepting new patients
Mercy Clinic Oklahoma Communities Internal Medicine CurrentSince Aug 8, 2014 Accepting new patients
Mercy Hospital Watonga Inc CurrentSince Jun 1, 2015 Accepting new patients
Mercy Hospital Tishomingo, Inc. CurrentSince Mar 20, 2018 Accepting new patients
Exceptional Physicians Group Ardmore Hospital PLLC CurrentSince Nov 9, 2024 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jun 1, 2020 Accepting new patients
Mercy Hospital Tishomingo, Inc CurrentSince Mar 20, 2018 Accepting new patients
Ehc Ardmore LLC PastSince Mar 12, 2024 Accepting new patients

Locations

1641 Woerz Way
Ardmore, OK 73401
Phone (436) 341-7800

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

3462 Hospital Rd
Healdton, OK 73438
Phone (580) 229-0701

1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

1000 S Byrd St
Tishomingo, OK 73460
Phone (580) 371-2327

500 N Clarence Nash Blvd
Watonga, OK 73772
Phone (580) 623-2233

3514 Cedar Springs Rd
Dallas, TX 75219
Phone (281) 415-6687

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1801089073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-752-3962",
            "fax_number": "405-752-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-752-3962",
            "fax_number": "405-752-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUCCI",
        "first_name": "DANIEL",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "25795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.