CARMINE MAZZUCA ACNPC-AG NPI 1003605064

NPI Information

  • NPI: 1003605064
  • Provider Name: CARMINE MAZZUCA, ACNPC-AG
  • Classification: Nurse Practitioner - 363LC0200X
  • Specialization: Critical Care Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 500 OSBORN BLVD
    SAULT SAINTE MARIE, MI
    ZIP 49783
  • Phone: (906) 635-4460

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NPI Details

Carmine Mazzuca, ACNPC-AG is a critical care medicine nurse practitioner in Sault Sainte Marie, MI with 2 years of experience. Carmine Mazzuca, ACNPC-AG NPI is 1003605064. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

500 OSBORN BLVD
SAULT SAINTE MARIE, MI
ZIP 49783-822
Phone: (906) 635-4460

The NPI 1003605064 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/5/2025 and was last updated on 10/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LC0200XNurse PractitionerCritical Care Medicine4704214883MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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