NPIMap

Individual provider Active NPI

Ralph Michael Cincinnati, C.R.N.P.

  • Nurse Practitioner
  • Wyomissing, PA
National Provider Identifier
1174580716
Registry record updated Oct 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP007277 Issued in PA
Practice address
1030 Reed Ave
Suite 116
Wyomissing, PA 19610-2039
Phone
(610) 373-7743
Fax
(610) 378-9337
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP007277 PA Primary

Addresses

Primary practice location

1030 Reed Ave
Suite 116
Wyomissing, PA 19610-2039

Mailing address

1030 Reed Ave
Suite 116
Wyomissing, PA 19610-2039
Phone (610) 373-7743

Other identifiers 1

IdentifierTypeStateIssuer
101001032MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040120000566 PA Practitioner - Nurse Practitioner 7719888916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berks Diabetes ManagementGroup PAC ID 6608186283, 3 clinicians

Practice addresses (Care Compare)

1030 Reed Ave
Suite 116
Wyomissing, PA 19610-2039
Phone (610) 373-7743

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.05 of 100Reported as individual
Quality
53.51
Improvement activities
40
Cost
70.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP007277PAMDNurse Practitioner

Organizations & group practices 1

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443916800000",
    "number": "1174580716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 REED AVE",
            "address_2": "SUITE 116",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102039",
            "telephone_number": "610-373-7743",
            "fax_number": "610-378-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 REED AVE",
            "address_2": "SUITE 116",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102039",
            "telephone_number": "610-373-7743",
            "fax_number": "610-378-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CINCINNATI",
        "first_name": "RALPH",
        "middle_name": "MICHAEL",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2015-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP007277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101001032",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.