Individual provider Active NPI

Meghan Angela Fuccella, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1932641578
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT292395 Issued in CA
Practice address
3401 Folsom Blvd Ste B
Sacramento, CA 95816-5354
Phone
(916) 455-5524
Fax
(916) 455-5584
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT292395 CA Primary

Addresses

Primary practice location

3401 Folsom Blvd Ste B
Sacramento, CA 95816-5354

Mailing address

3401 Folsom Blvd Ste B
Sacramento, CA 95816-5354
Phone (916) 455-5524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170210001778 CA Practitioner - Physical Therapist in Private Practice 5496038762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parry Physical Therapy and Athletic Enhancement, Inc.Group PAC ID 8224034616, 5 clinicians

Practice addresses (Care Compare)

3401 Folsom Blvd
Suite B
Sacramento, CA 95816-5354
Phone (916) 455-5524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT292395CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Parry Physical Therapy & Athletic Enhancement, Inc. Physical Therapist CurrentSince May 1, 2021 Accepting new patients

Locations

3401 Folsom Blvd
Ste B
Sacramento, CA 95816
Phone (916) 455-5524

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.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1932641578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 FOLSOM BLVD STE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165354",
            "telephone_number": "916-455-5524",
            "fax_number": "916-455-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 FOLSOM BLVD STE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165354",
            "telephone_number": "916-455-5524",
            "fax_number": "916-455-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCCELLA",
        "first_name": "MEGHAN",
        "middle_name": "ANGELA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT292395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.