Individual provider Active NPI

Michael S Cicchetti, MD

  • Physical Medicine & Rehabilitation Physician
  • Williamsville, NY
National Provider Identifier
1164644183
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
251201 Issued in NY
Practice address
100 College Pkwy
Suite 100
Williamsville, NY 14221-6800
Phone
(434) 924-2047
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 251201 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X 0116017375 VA

Addresses

Primary practice location

100 College Pkwy
Suite 100
Williamsville, NY 14221-6800

Mailing address

100 College Pkwy
Suite 100
Williamsville, NY 14221-6800
Phone (716) 626-0093

Other identifiers 1

IdentifierTypeStateIssuer
03110469MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090626000383 NY Practitioner - Physical Medicine and Rehabilitation 1254482565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Virginia School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buffalo Spine Medicine and Rehab PLLCGroup PAC ID 8921253089, 15 clinicians

Practice addresses (Care Compare)

100 College Pkwy
Suite 100
Williamsville, NY 14221-6800
Phone (716) 626-0093

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.75 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116017375VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Spine Medicine & Rehab PLLC Physical Medicine & Rehabilitation CurrentSince Nov 6, 2012 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

100 College Pkwy
Ste 100
Williamsville, NY 14221
Phone (716) 362-1552

Organizations & group practices 2

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1164644183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216800",
            "telephone_number": "716-626-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLLEGE PKWY",
            "address_2": "SUITE 100",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216800",
            "telephone_number": "434-924-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCHETTI",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "251201",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116017375",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03110469",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.