Organization Active NPI

Joseph Ciccarello DC PA

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1255603080
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2023 Issued in FL
Legal business name
JOSEPH CICCARELLO DC PA
Practice address
1011 S US Highway 301
Tampa, FL 33619-4903
Phone
(813) 621-3180
Fax
(813) 626-2225
NPI assigned
Feb 9, 2012
Last updated
Feb 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Mrs. Robin E Hines
Title
Billing
Phone
(352) 796-9636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2023 FL Primary

Addresses

Primary practice location

1011 S US Highway 301
Tampa, FL 33619-4903

Mailing address

1011 S US Highway 301
Tampa, FL 33619-4903
Phone (813) 621-3180

Other identifiers 1

IdentifierTypeStateIssuer
050781400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120215000158 FL Part B Supplier - Clinic/Group Practice 6406014844 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

1011 S US Highway 301
Tampa, FL 33619
Phone (813) 621-2180

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1255603080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 S US HIGHWAY 301",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194903",
            "telephone_number": "813-621-3180",
            "fax_number": "813-626-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S US HIGHWAY 301",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194903",
            "telephone_number": "813-621-3180",
            "fax_number": "813-626-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH CICCARELLO DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "352-796-9636",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050781400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.