Individual provider Active NPI

Cecilia R Ventura, MD

  • Pediatrics Physician
  • Scranton, PA
National Provider Identifier
1275518169
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD020503E Issued in PA
Practice address
959 Wyoming Ave
Scranton, PA 18509-3023
Phone
(570) 344-3517
Fax
(570) 344-6839
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD020503E PA Primary

Addresses

Primary practice location

959 Wyoming Ave
Scranton, PA 18509-3023

Mailing address

PO Box 31
959 Wyoming Ave.
Scranton, PA 18501-0031
Phone (570) 344-3517

Other identifiers 1

IdentifierTypeStateIssuer
0006601460002MedicaidPA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD020503EPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Primary Health Care Center, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1275518169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31",
            "address_2": "959 WYOMING AVE.",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185010031",
            "telephone_number": "570-344-3517",
            "fax_number": "570-344-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 WYOMING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185093023",
            "telephone_number": "570-344-3517",
            "fax_number": "570-344-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "CECILIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD020503E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006601460002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.