Individual provider Active NPI

Mark T Bucci, PA-C

  • Physician Assistant
  • Naples, FL
National Provider Identifier
1851713713
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107743 Issued in FL
Practice address
1706 Medical Blvd Ste 201
Naples, FL 34110-1417
Phone
(239) 593-3500
Fax
(239) 593-9163
NPI assigned
Jan 13, 2014
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9107743 FL Primary

Addresses

Primary practice location

1706 Medical Blvd Ste 201
Naples, FL 34110-1417

Mailing address

1706 Medical Blvd Ste 201
Naples, FL 34110-1417
Phone (239) 593-3500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140312001202 FL Practitioner - Physician Assistant 5890924476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collier Sports Medicine and Orthopaedic Center PAGroup PAC ID 1153219324, 4 clinicians

Practice addresses (Care Compare)

1706 Medical Blvd
Naples, FL 34110-1417
Phone 2395933500206

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9107743FLMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1851713713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 MEDICAL BLVD STE 201",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101417",
            "telephone_number": "239-593-3500",
            "fax_number": "239-593-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 MEDICAL BLVD STE 201",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101417",
            "telephone_number": "239-593-3500",
            "fax_number": "239-593-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCI",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.