Nicoletta Stefina Ciraulo, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

5601009975 Issued in MI

Practice address

1979 Huron Pkwy
Ann Arbor, MI 48104-4141

Phone

(734) 344-4567

NPI assigned

Mar 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chicago Cosmetic Surgery and Dermatology SCGroup PAC ID 8325005150, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Chicago Cosmetic Surgery and Dermatology SC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1407068000
  Medicare reassignment Care Compare group
• Laura K Ganger, M.D. P.C.

  dba Ganger Dermatology

  • Dermatology Physician
  • Ann Arbor, MI
  • NPI 1720347248

  Single Specialty

  NPD
• Derick Dermatology, PLLC

  • Dermatology Physician
  • Arlington Heights, IL
  • NPI 1497792618

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1326674441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1979 HURON PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044141",
            "telephone_number": "734-344-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 HURON PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044141",
            "telephone_number": "734-344-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRAULO",
        "first_name": "NICOLETTA",
        "middle_name": "STEFINA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601009975",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5601009975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Cin, MD
• Jacob Cindrich, MD
• Sandro Kurt Cinti, MD
• Madeline Nicole Ciofu
• Leah Cipri
• Circle of Life Psychiatric Hospital
• Therese Cirner, LPC
• Sarah Cissell, LMSW
• Citta Mental Health Services
• City of Ann Arbor

• Dermatology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.