NPIMap

Individual provider Active NPI

Mark Cruciani, MD

  • Rheumatology Physician
  • Scranton, PA
National Provider Identifier
1235171646
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD041260L Issued in PA
Practice address
1418 Wyoming Ave
Scranton, PA 18509
Phone
(570) 341-9730
Fax
(570) 341-9731
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD041260L PA Primary

Addresses

Primary practice location

1418 Wyoming Ave
Scranton, PA 18509

Mailing address

1418 Wyoming Ave
Scranton, PA 18509
Phone (570) 341-9730

Other identifiers 12

IdentifierTypeStateIssuer
E55838OtherPASTERLING
077077Other1ST PRIORITY
614715OtherPAFEDERAL BLUE SHIELD
505461OtherAETNA
614715OtherPAPA BLUE SHIELD
73790OtherPAMEDPLUS
614715OtherPAFIRST PRIORITY LIFE
PC0196OtherPACHAMPUS
2Y8654OtherHLTH NET
12093 200OtherPAGEISINGER HEALTH
18787OtherGEISINGER
505471OtherPAAETNA

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
I20091230000222 PA Practitioner - Rheumatology 5092855882 Practice locations: Scranton, PA

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Georgetown University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1418 Wyoming Ave
Scranton, PA 18509-2330
Phone (570) 341-9730

Hospital & facility affiliations

National Provider Directory

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

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1235171646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 WYOMING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18509",
            "telephone_number": "570-341-9730",
            "fax_number": "570-341-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 WYOMING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18509",
            "telephone_number": "570-341-9730",
            "fax_number": "570-341-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUCIANI",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD041260L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING",
            "identifier": "E55838",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST PRIORITY",
            "identifier": "077077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE SHIELD",
            "identifier": "614715",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "505461",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "614715",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDPLUS",
            "identifier": "73790",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY LIFE",
            "identifier": "614715",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "PC0196",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLTH NET",
            "identifier": "2Y8654",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH",
            "identifier": "12093 200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "18787",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "505471",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.