Individual provider Active NPI

Michael Scott Tucker, M.D.

  • Dermatology Physician
  • Naples, FL
National Provider Identifier
1922033471
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME73990 Issued in FL
Practice address
9125 Corsea del Fontana Way
Suite 100
Naples, FL 34109-4396
Phone
(239) 598-4004
NPI assigned
Jul 12, 2006
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME73990 FL Primary

Addresses

Primary practice location

9125 Corsea del Fontana Way
Suite 100
Naples, FL 34109-4396

Mailing address

2143 Marina Dr
Naples, FL 34102-7627
Phone (239) 262-6843

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
I20101018000185 FL Practitioner - Dermatology 3173578622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Texas Tech University Health Science Center School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

9125 Corsea del Fontana Way
Suite 100
Naples, FL 34109-4430
Phone (239) 598-4004

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision83
Removal of skin lesions2332
Removal of skin cancer194
Removal or shaving of skin growth228
Skin biopsy802

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME73990FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Florida, PA Dermatology CurrentSince Mar 1, 2016 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Mar 1, 2016 Accepting new patients

Locations

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

9125 Corsea del Fontana Way
Ste 100
Naples, FL 34109
Phone (239) 598-4004

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mtucker@aquadermatology.emadirect.md

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1922033471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 MARINA DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341027627",
            "telephone_number": "239-262-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 CORSEA DEL FONTANA WAY",
            "address_2": "SUITE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341094396",
            "telephone_number": "239-598-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME73990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.