NPIMap

Individual provider Active NPI

Robert Lee Marcaccini, MD, PHARM.D.

  • Plastic Surgery Physician
  • Saint Cloud, MN
National Provider Identifier
1972935583
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
76540 Issued in MN
Practice address
3701 12TH St N Ste 100
Saint Cloud, MN 56303-2253
Phone
(320) 253-7257
Fax
(320) 251-2938
NPI assigned
Aug 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A195410 CA
Pharmacist 183500000X 121293 MN
Plastic Surgery Physician 208200000X 76540 MN Primary

Addresses

Primary practice location

3701 12TH St N Ste 100
Saint Cloud, MN 56303-2253

Mailing address

1200 6TH Ave N
Saint Cloud, MN 56303-2735
Phone (320) 251-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250827000175 MN Practitioner - Plastic and Reconstructive Surgery 6103173935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

3701 12TH St N
Suite 100
Saint Cloud, MN 56303-2253
Phone (320) 253-7257

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Aug 1, 2025 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Aug 1, 2025 Accepting new patients
Centracare Clinic CurrentSince Aug 1, 2025 Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

3701 12th St N
Ste 100
Saint Cloud, MN 56303
Phone (320) 253-7257

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: rmarcaccini887480@direct.centracare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1972935583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032253",
            "telephone_number": "320-253-7257",
            "fax_number": "320-251-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCACCINI",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD, PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-06",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A195410",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "121293",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MN",
            "license": "76540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.