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DR. THEODORE A BUCCILLI JR. DPM
NPI 1164413019
Podiatrist in Ravenna, OH

Active since October 31, 2005
4403 CLOVER DR, RAVENNA, OH 44266(330) 687-7464 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 15, 2025, Mar 1, 2019, Jul 15, 2016 (3 updates tracked since 2016).

About Dr. Theodore A Buccilli Jr. Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE A BUCCILLI JR. DPM (NPI 1164413019) is an individual podiatrist in Ravenna, Ohio, licensed in Ohio (36003352) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1164413019
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. THEODORE A BUCCILLI JR.Credential: DPM
Location Address4403 CLOVER DRRavenna, OH 44266-8636
Mailing Address5500 Armstrong RdBattle Creek, MI 49037-7314 · (269) 966-5600
Phone(330) 687-7464
Sole ProprietorYes
Enumeration DateOctober 31, 2005
Last NPPES UpdateAugust 15, 20253 updates tracked since enumeration
NPPES CertifiedAugust 15, 2025
✔ NPI 1164413019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in OH · 36003352
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
4403 CLOVER DR, Ravenna, OH 44266
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months
72%185 patients3/55-star benchmark: 100%
Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear
Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who were evaluated for proper footwear and sizing
73%199 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%1,490 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
30%43 patients1/55-star benchmark: 100%
Falls: Plan of Care
Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months
100%33 patients5/55-star benchmark: 100%
Falls: Risk Assessment
Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months
97%33 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
61%233 patients3/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
12%52 patients1/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
62%257 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Buccilli's NPI number?

The NPI number for Theodore Buccilli is 1164413019. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Where is Theodore Buccilli located?

Theodore Buccilli practices at 4403 Clover Dr, Ravenna, OH 44266. The listed phone number is (330) 687-7464.

What is Theodore Buccilli's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

What insurance does Theodore Buccilli accept?

Health plans from CareSource list Theodore Buccilli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Theodore Buccilli was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.