Individual provider Active NPI

Joseph Vincent Ciampoli, CRNA

  • Certified Registered Nurse Anesthetist
  • State College, PA
National Provider Identifier
1174886196
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN593822 Issued in PA
Practice address
1800 E Park Ave
State College, PA 16803-6709
Phone
(814) 231-7000
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN593822 PA Primary
Certified Registered Nurse Anesthetist 367500000X 146061 TX

Addresses

Primary practice location

1800 E Park Ave
State College, PA 16803-6709

Mailing address

PO Box 16
State College, PA 16804-0016
Phone (814) 466-5090

Other identifiers 1

IdentifierTypeStateIssuer
1031131900001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713000850 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668628983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Nittany Medical CenterGroup PAC ID 2365353364, 45 clinicians

Practice addresses (Care Compare)

1800 E Park Ave
State College, PA 16803-6797
Phone (814) 231-7000

Hospital & facility affiliations

  • Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
146061TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center CurrentSince May 18, 2016 Accepting new patients
Mount Nittany Medical Center Nurse Anesthetist, Certified Registered CurrentSince May 18, 2016 Accepting new patients

Locations

1850 E Park Ave
State College, PA 16803
Phone (814) 234-6750

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

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 5

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1174886196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168040016",
            "telephone_number": "814-466-5090",
            "fax_number": "814-466-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036709",
            "telephone_number": "814-231-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAMPOLI",
        "first_name": "JOSEPH",
        "middle_name": "VINCENT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN593822",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "146061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031131900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.