Individual provider Active NPI

Anthony Albert Iadicicco

  • Registered Nurse
  • McKeesport, PA
National Provider Identifier
1295550770
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN549136 Issued in PA
Practice address
4201 Walnut St
McKeesport, PA 15132-7300
Phone
(724) 994-9777
NPI assigned
Nov 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN549136 PA Primary

Addresses

Primary practice location

4201 Walnut St
McKeesport, PA 15132-7300

Mailing address

4201 Walnut St
McKeesport, PA 15132-7300
Phone (724) 994-9777

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

State licenses

LicenseStateTypeSpecialty
RN549136PAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1295550770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WALNUT ST",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151327300",
            "telephone_number": "724-994-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 WALNUT ST",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151327300",
            "telephone_number": "724-994-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IADICICCO",
        "first_name": "ANTHONY",
        "middle_name": "ALBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN549136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKeesport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.