Lori Lynn Ciccone, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001888 Issued in CT

Practice address

350 Goose LN Ste 203B
Guilford, CT 06437-2492

Phone

(203) 932-6481

Fax

(039) 324-0512

NPI assigned

Mar 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The William W Backus Hospital 248 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• William W Backus Hospital Hospital, Norwich, CT, CCN 070024

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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.

• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235

  CT

  Medicare reassignment Care Compare group
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536
  NPD
• Bert Coppotelli MD LLC

  • Family Medicine Physician
  • Lisbon, CT
  • NPI 1699969469
  NPD (past)
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  NPD (past)
• Mark D. Deponte, M.D.,LLC

  • Family Medicine Physician
  • Lisbon, CT
  • NPI 1548591597
  NPD (past)

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

• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1467517235

  Hospital

  Care Compare affiliation
• The William W Backus Hospital

  • General Acute Care Hospital
  • Norwich, CT
  • NPI 1639135718

  Hospital

  Care Compare affiliation
• William W Backus Hospital

  • Psychiatric Hospital Unit
  • Norwich, CT
  • NPI 1730243536

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1205964426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E MAIN ST STE 1B",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053136",
            "telephone_number": "034-887-2282",
            "fax_number": "203-204-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 GOOSE LN STE 203B",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372492",
            "telephone_number": "203-932-6481",
            "fax_number": "039-324-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCONE",
        "first_name": "LORI",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001888",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "001888",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lori.ciccone@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Cellini Pl Ste 102",
            "city": "West Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065161666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Guilford, CT
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.
• 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.