Individual provider Active NPI

Victoria Cimino, MD MPH

  • Internal Medicine Physician
  • Yardley, PA
National Provider Identifier
1447647516
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD465036 Issued in PA
Practice address
1666 Edgewood Rd
Yardley, PA 19067-5547
Phone
(215) 493-2231
NPI assigned
Apr 16, 2015
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD465036 PA Primary

Addresses

Primary practice location

1666 Edgewood Rd
Yardley, PA 19067-5547

Mailing address

1666 Edgewood Rd
Yardley, PA 19067-5547
Phone (215) 493-2231

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180817002258 PA Practitioner - Internal MedicinePractitioner - General Practice 4981953387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD465036PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Pennsylvania Holding, LLC Internal Medicine Current Accepting new patients
Dedicated Pennsylvania Holding, LLC Internal Medicine CurrentSince Jul 31, 2018 Accepting new patients
Dedicated Pennsylvania Holding, LLC Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1447647516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 EDGEWOOD RD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675547",
            "telephone_number": "215-493-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 EDGEWOOD RD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675547",
            "telephone_number": "215-493-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMINO",
        "first_name": "VICTORIA",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD465036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.