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LOGAN ALEXANDER PUCCI MD
NPI 1417751074
Student in an Organized Health Care Education/Training Program in Charlottesville, VA

Active since April 02, 2025PECOS Enrolled
1215 LEE ST, CHARLOTTESVILLE, VA 22908(434) 243-5600(434) 244-9450 Get Directions Write a Review

NPPES record last updated: June 14, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Logan Alexander Pucci Md NPPES

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

LOGAN ALEXANDER PUCCI MD (NPI 1417751074) is an individual student in an organized health care education/training program in Charlottesville, Virginia and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417751074
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameLOGAN ALEXANDER PUCCICredential: MD
Location Address1215 LEE STCharlottesville, VA 22908-0816
Mailing Address1215 Lee St, Box 801007Charlottesville, VA 22908-0816 · (434) 243-5600 · Fax (434) 244-9450
Phone(434) 243-5600
Fax(434) 244-9450
Sole ProprietorNo
Enumeration DateApril 2, 2025
Last NPPES UpdateJune 14, 2026
NPPES CertifiedJune 14, 2026
✔ NPI 1417751074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1215 LEE ST, Charlottesville, VA 22908
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Logan Alexander Pucci Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORMA BRANHAM R.N., N.P.
Nurse Practitioner
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2047
FARNAZ M GAZONI MD
Anesthesiology
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2283
MARGARET K. SANDE M.D.
Emergency Medicine
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2231
KATHERINE T, FORKIN M.D.
Anesthesiology
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-2283
AMBER N. INOFUENTES M.D.
Hospitalist
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 243-4288
JOY R MILLER PNP
Nurse Practitioner (Pediatrics)
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 243-2617
DR. DARREN GUFFEY M.D.
Dermatology
1215 LEE ST, BOX 800744
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-1931
SETH MORRISON MD
Pediatrics (Pediatric Gastroenterology)
1215 LEE ST
CHARLOTTESVILLE, VA 22908
Charlottesville City (434) 924-3627

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 Logan Pucci's NPI number?

The NPI number for Logan Pucci is 1417751074. It was assigned to this individual provider in the NPPES registry on April 2, 2025.

Where is Logan Pucci located?

Logan Pucci practices at 1215 Lee St, Charlottesville, VA 22908. The listed phone number is (434) 243-5600.

What is Logan Pucci's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Logan Pucci enrolled in Medicare?

Yes. Logan Pucci is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Logan Pucci was last updated on June 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.