Baltazar L Corcino, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD031136L Issued in PA

Practice address

531 Hannah St
Clearfield, PA 16830-1209

Phone

(814) 765-1982

Fax

(814) 765-8213

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mature Resources Foundation

  dba Susquehanna Wellness Clinic

  • Family Medicine Physician
  • Frenchville, PA
  • NPI 1447861521
  NPD
• Clear Med Provider Corporation

  • Health Service Clinic/Center
  • Philipsburg, PA
  • NPI 1083872766
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1174574867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 TURNPIKE AVE",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301232",
            "telephone_number": "814-768-2356",
            "fax_number": "814-768-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 HANNAH ST",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301209",
            "telephone_number": "814-765-1982",
            "fax_number": "814-765-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCINO",
        "first_name": "BALTAZAR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD031136L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006187790004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006187790005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Nurses Home Health and Hospice Inc (Penn Highlands Community Nurses)
• Community Nurses Home Health and Hospice Inc (Penn Highlands Community Nurses)
• Tina Marie Connor, PHARMD
• Donald E. Conrad, D.O.
• Brooke Cook, LPC
• Alfred B Coren, M.D.
• Amy D. Criscitello, CRNP
• Julie Curry, LSW
• Michelle Lea Curry, CRNP
• Amber Renee Ivory Daniels, CRNP

• Internal Medicine Physician in Clearfield, PA
• Providers in Clearfield, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.