Individual provider Active NPI

Lyam Ciccone, MD

  • Gastroenterology Physician
  • Panama City, FL
National Provider Identifier
1467018002
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
171344 Issued in FL
Practice address
204 E 19TH St
Panama City, FL 32405-4707
Phone
(850) 763-5409
NPI assigned
May 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 171344 FL Primary

Addresses

Primary practice location

204 E 19TH St
Panama City, FL 32405-4707

Mailing address

20 Exchange PL Apt 615
New York, NY 10005-3280
Phone (862) 251-0451

Other practice location 1

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250502002770 FL Practitioner - Gastroenterology 4789101700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Diseases Center of Florida PLLCGroup PAC ID 0345227328, 15 clinicians

Practice addresses (Care Compare)

204 E 19TH St
Panama City, FL 32405-4707
Phone (850) 763-5409

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy38
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
171344FLMDTechnician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Diseases Center of Florida, PLLC CurrentSince Apr 28, 2025 Accepting new patients
Digestive Diseases Center of Florida, PLLC Past Accepting new patients

Locations

204 E 19th St
Panama City, FL 32405
Phone (850) 763-5409

Interoperability endpoints

  • Direct secure messaging: lyam.ciccone.p1@direct.ddc.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1467018002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EXCHANGE PL APT 615",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100053280",
            "telephone_number": "862-251-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICCONE",
        "first_name": "LYAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "171344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.