Active NPI
Lee Michael Ciccarelli, M.D.
- Specialist
- Williamsport, PA
National Provider Identifier
1417909029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD022616E
- Practice address
- 429 Washington Blvd
Williamsport, PA 17701-5255 - Phone
- (570) 327-9480
- Fax
- (570) 327-9483
- NPI assigned
- May 16, 2006
- Last updated
- Jan 4, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | MD022616E | PA | |
| Specialist | 174400000X | MD022616E | PA | Primary |
Addresses
Primary practice location
429 Washington Blvd
Williamsport, PA 17701-5255
Mailing address
429 Washington Blvd
Williamsport, PA 17701-5255
Phone (570) 327-9480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050615000633 | PA | Practitioner - Geriatric Medicine | 6305880899 | Practice locations: Williamsport, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Geriatric Medicine
- Education
- Wake Forest University School of Medicine, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- H2 Rehabilitation Extension Services LLCPhoenix Rehabilitation and Health Services Inc
Practice addresses (Care Compare)
1948 E 3Rd St
Suite C
Williamsport, PA 17701-3945
Phone (570) 327-1760
2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238
Hospital & facility affiliations
- Upmc Home Healthcare
- Family Hospice
- Upmc Williamsport
- Geisinger Medical Center
- Geisinger Jersey Shore Hospital
- Upmc Wellsboro
- Upmc Muncy
- Williamsport Home, The
- Valley View Rehab and Nursing Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 22.86 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 76.19
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Williamsport Home | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Skilled Nursing Facility
- Williamsport, PA
- NPI 1336149129
Hospital & facility affiliations 45
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Jersey Shore, PA
- NPI 1366407587
-
dba Geisinger Medical Oncology Selinsgrove, a Service of GMC
- General Acute Care Hospital
- Danville, PA
- NPI 1013384809
-
- General Acute Care Hospital
- Coal Township, PA
- NPI 1033491741
-
- Psychiatric Hospital Unit
- Danville, PA
- NPI 1144301102
-
- General Acute Care Hospital
- Lewisburg, PA
- NPI 1154617694
-
- General Acute Care Hospital
- Danville, PA
- NPI 1235215427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1417909029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 WASHINGTON BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177015255",
"telephone_number": "570-327-9480",
"fax_number": "570-327-9483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "429 WASHINGTON BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177015255",
"telephone_number": "570-327-9480",
"fax_number": "570-327-9483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCARELLI",
"first_name": "LEE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "PA",
"license": "MD022616E",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD022616E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.