NPIMap

Individual provider Active NPI

Cynthia Ciccotelli, MD

  • Family Medicine Physician
  • Bloomsburg, PA
National Provider Identifier
1467036111
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD486011 Issued in PA
Practice address
240 Mall Blvd
Bloomsburg, PA 17815-8306
Phone
(570) 784-8303
Fax
(570) 387-5030
NPI assigned
May 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD486011 PA Primary

Addresses

Primary practice location

240 Mall Blvd
Bloomsburg, PA 17815-8306

Mailing address

100 N Academy Ave Ste 140
Danville, PA 17822-4903
Phone (570) 784-8303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240924001746 PA Practitioner - Family Practice 0840692331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

240 Mall Blvd
Bloomsburg, PA 17815-8389
Phone (570) 416-5435

Hospital & facility affiliations

  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003
  • Geisinger Encompass Health Rehabilitation Hospital Inpatient rehabilitation facility, Danville, PA, CCN 393047

Merit-based Incentive Payment System (MIPS)

Final score
95.15 of 100Reported as apm
Quality
83.54
Promoting interoperability
94.52
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD486011PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Sep 4, 2024 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine Current Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Sep 4, 2024 Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Sep 4, 2024 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Sep 4, 2024 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

240 Mall Blvd
Bloomsburg, PA 17815
Phone (570) 416-5435

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

100 N Academy Ave
Ste 140
Danville, PA 17822

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

Interoperability endpoints

  • Direct secure messaging: cciccotelli608029@direct.geisinger.edu

Organizations & group practices 7

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1467036111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE STE 140",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-784-8303",
            "fax_number": "570-387-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MALL BLVD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158306",
            "telephone_number": "570-784-8303",
            "fax_number": "570-387-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCOTELLI",
        "first_name": "CYNTHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD486011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.