Augusto Jorge Cianciabella, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

10502 Park Rd Ste 120
Charlotte, NC 28210-8490

Phone

(704) 702-3880

NPI assigned

Feb 2, 2009

Last updated

Aug 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2021 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Vip Neurology

  • Neurology Physician
  • Merritt Island, FL
  • NPI 1659774685
  NPD (past)

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1093953838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10502 PARK RD STE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108490",
            "telephone_number": "704-702-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 PARK RD STE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108490",
            "telephone_number": "704-702-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIANCIABELLA",
        "first_name": "AUGUSTO",
        "middle_name": "JORGE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20179",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9105911",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "Y06SS",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "PA20179",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SECUREME",
            "affiliation": "N",
            "endpointDescription": "ENCRYPTED E-MAILING SERVICE",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Questionnaires",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Questionnaires",
            "address_1": "10502 Park Rd Ste 120",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura B Church, PHARMD
• Lindsey Nicole Church, MSW, LCSW
• Nicole A. Church, BCBA
• Kimberly Ann Churchill, PA-C
• David Anthony Ciaccia, DO
• Jennifer Dehaven Cianciolo, LCSW
• Nelsa A Ciapponi, M.D.
• Joseph Ciccarello, PHARM.D., M.B.A.
• Julia Cichowitz, MSW, LCSWA
• Ciepcielinski Counseling, PLLC

• Surgical Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Surgical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.