Charles L Pucevich, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD0272SOE Issued in PA

Practice address

500 Cherrington Pkwy Ste 410
Coraopolis, PA 15108-4749

Phone

(412) 262-1064

Fax

(412) 262-3904

NPI assigned

Oct 18, 2005

Last updated

Mar 8, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Charles L. Pucevich, M.D.

  • Rheumatology Physician
  • Coraopolis, PA
  • NPI 1780731133
  NPD
• Dermatology Associates of Western Pennsylvania Inc.

  • Dermatology Physician
  • Coraopolis, PA
  • NPI 1205271624
  NPD (past)
• Dermatology Associates of Western Pennsylvania Inc.

  dba Dermatology Associates of Western Pennsylvania

  • Dermatology Physician
  • Coraopolis, PA
  • NPI 1467509810
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1942299383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHERRINGTON PKWY STE 410",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151084749",
            "telephone_number": "412-262-1064",
            "fax_number": "412-262-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHERRINGTON PKWY STE 410",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151084749",
            "telephone_number": "412-262-1064",
            "fax_number": "412-262-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCEVICH",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD0272SOE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0863588",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dane R Plunkett, DMD
• James Michael Ponce, LPC
• Jennifer Slane Porco, PH.D.
• Kathleen Prince-Pennington, LPC MS ED
• Brian Edward Pucevich, M.D.
• Maria Valiente Pucevich, MD
• Qpharma Inc
• Joanne Kathryn Racicot, RPH
• Ryan Raible
• Ann Marie Rapone

• Rheumatology Physician in Coraopolis, PA
• Providers in Coraopolis, PA by specialty
• Rheumatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.