Individual provider Active NPI

Michael Jon Cicale, MD

  • Pulmonary Disease Physician
  • Durham, NC
National Provider Identifier
1073696225
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
2003-00018 Issued in NC
Practice address
508 Fulton St
Durham, NC 27705-3875
Phone
(919) 286-0411
Fax
(919) 416-5938
NPI assigned
Oct 23, 2006
Last updated
Apr 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME109346 FL
Pulmonary Disease Physician 207RP1001X 2003-00018 NC Primary

Addresses

Primary practice location

508 Fulton St
Durham, NC 27705-3875

Mailing address

508 Fulton St
Durham, NC 27705-3875
Phone (919) 286-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926002690 NC Order and Referring Only - Pulmonary DiseasePractitioner - Pulmonary Disease 3274566260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003-00018NCMDPulmonary Disease Physician
00018NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of North Carolina PLLC Past Accepting new patients
Hospitalist Medicine Physicians of Durham County, PLLC Past Accepting new patients
Hospitalist Medicine Physicians of Forsyth County, PLLC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1073696225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411",
            "fax_number": "919-416-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411",
            "fax_number": "919-416-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICALE",
        "first_name": "MICHAEL",
        "middle_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME109346",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2003-00018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.