Individual provider Active NPI

Cynthia Rose Cuyegkeng-Jose, MD

  • Anesthesiology Physician
  • Scranton, PA
National Provider Identifier
1487635413
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD025259E Issued in PA
Practice address
1800 Mulberry St.
Scranton, PA 18510-6800
Phone
(570) 703-8259
Fax
(570) 703-7250
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD025259E PA Primary

Addresses

Primary practice location

1800 Mulberry St.
Scranton, PA 18510-6800

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 3

IdentifierTypeStateIssuer
188954OtherPAMEDICARE
050017926OtherPARR MEDICARE
0931122MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccuyegkengjose102035@direct.geisinger.edu Direct

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
I20100714000461 PA Practitioner - Anesthesiology 5193617553 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD025259EPAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2016 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2016 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: ccuyegkengjose102035@direct.geisinger.edu

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1487635413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MULBERRY ST.",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185106800",
            "telephone_number": "570-703-8259",
            "fax_number": "570-703-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUYEGKENG-JOSE",
        "first_name": "CYNTHIA",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD025259E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "188954",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050017926",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0931122",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccuyegkengjose102035@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Mulberry St.",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185106800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.