Brad Ciccolella, PT, MPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT018032 Issued in PA

Practice address

3053 New Germany Rd
Ebensburg, PA 15931-3516

Phone

(800) 332-5740

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, 750 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Keystone Rehabilitation Systems, Inc.

  • Physical Therapy Clinic/Center
  • Dingmans Ferry, PA
  • NPI 1164944245
  Medicare reassignment Care Compare group
• Keystone Rehabilitation Systems, Inc.

  • Physical Therapy Clinic/Center
  • Macungie, PA
  • NPI 1205386547
  NPD
• Keystone Rehabilitation Systems, Inc.

  • Physical Therapy Clinic/Center
  • Butler, PA
  • NPI 1336878941
  NPD
• Mountain State Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Fairmont, WV
  • NPI 1083668875
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1346328465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 NEW GERMANY RD",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159313516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3053 NEW GERMANY RD",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159313516",
            "telephone_number": "800-332-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCOLELLA",
        "first_name": "BRAD",
        "credential": "PT, MPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMP",
            "identifier": "1066644",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1845645",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101582673-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Gregory Cesarz, OTA
• Amy Chakot
• Chariot Ebensburg Alf Opco LLC
• Chariot Ebensburg SNF Opco LLC
• Robert Stephen Chippie Jr., CRNP
• CJT Counseling PC
• Caitlyn Claar
• Jeanne Rene Clark, RN
• Jenna Mae Cochran, RN
• Lisa Marie Cochran, OT

• Physical Therapist in Ebensburg, PA
• Providers in Ebensburg, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.