Individual provider Active NPI

Dennis A Tuck, DPM

  • Podiatrist
  • Peabody, MA
National Provider Identifier
1992852099
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1640 Issued in MA
Practice address
100 Brooksby Village Dr
Peabody, MA 01960-1438
Phone
(978) 536-7580
Fax
(877) 280-9727
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1640 MA Primary

Addresses

Primary practice location

100 Brooksby Village Dr
Peabody, MA 01960-1438

Mailing address

5525 Research Park Drive
4TH Floor
Baltimore, MD 21228-4664
Phone (978) 536-7850

Other identifiers 1

IdentifierTypeStateIssuer
110015405AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000585 MA Practitioner - PodiatryPractitioner - Orthopedic Surgery 7719052760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Podiatry Group PCGroup PAC ID 3375446958, 105 clinicians

Practice addresses (Care Compare)

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5401
Phone (617) 964-6681

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue2257
Removal or shaving of skin growth621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1640MAMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992852099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 RESEARCH PARK DRIVE",
            "address_2": "4TH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284664",
            "telephone_number": "978-536-7850",
            "fax_number": "877-280-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROOKSBY VILLAGE DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601438",
            "telephone_number": "978-536-7580",
            "fax_number": "877-280-9727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK",
        "first_name": "DENNIS",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110015405A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.