Individual provider Active NPI

Nicole M. Cicchino, DO

  • Pediatrics Physician
  • Bensalem, PA
National Provider Identifier
1235397167
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS015576 Issued in PA
Practice address
2217 Bristol Pike
Bensalem, PA 19020-5720
Phone
(215) 638-0555
Fax
(215) 638-2929
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.009317 OH
Pediatrics Physician 208000000X OS015576 PA Primary

Addresses

Primary practice location

2217 Bristol Pike
Bensalem, PA 19020-5720

Mailing address

2217 Bristol Pike
Bensalem, PA 19020-5720
Phone (215) 638-0555

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170615000288 PA Practitioner - Pediatric Medicine 4385717685 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.009317OHMDPediatrics Physician
OS015576PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Apr 9, 2017 Accepting new patients
Advocare, LLC Pediatrics CurrentSince Apr 9, 2017 Accepting new patients
Jerome H. Horowitz, M.D.,P.C. Pediatrics Past Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
True North Medical Group, LLC Pediatrics Past Accepting new patients

Locations

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

1991 Sproul Rd
Ste 40A
Broomall, PA 19008
Phone (610) 324-1400

1100 Horizon Cir
Ste 101
Chalfont, PA 18914
Phone (215) 394-0400

Interoperability endpoints

  • Direct secure messaging: nicole.cicchino@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1235397167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 BRISTOL PIKE",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205720",
            "telephone_number": "215-638-0555",
            "fax_number": "215-638-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 BRISTOL PIKE",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205720",
            "telephone_number": "215-638-0555",
            "fax_number": "215-638-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCHINO",
        "first_name": "NICOLE",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.009317",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS015576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

Verify at the official NPI Registry.