Active NPI
Dennis B Cicchino, PA
- Physician Assistant
- Rensselaer, NY
National Provider Identifier
1245290626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 000480
- Practice address
- 2 Empire Dr
Rensselaer, NY 12144-5730 - Phone
- (518) 286-4899
- Fax
- (518) 286-4859
- NPI assigned
- Mar 28, 2006
- Last updated
- May 9, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000480 | NY | Primary |
Addresses
Primary practice location
2 Empire Dr
Rensselaer, NY 12144-5730
Mailing address
PO Box 689
Troy, NY 12181-0689
Phone (518) 268-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01819910 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1245290626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 689",
"city": "TROY",
"state": "NY",
"postal_code": "121810689",
"telephone_number": "518-268-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 EMPIRE DR",
"city": "RENSSELAER",
"state": "NY",
"postal_code": "121445730",
"telephone_number": "518-286-4899",
"fax_number": "518-286-4859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCHINO",
"first_name": "DENNIS",
"middle_name": "B",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "000480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01819910",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rensselaer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.