Michael Civitello, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT010031L Issued in PA

Practice address

812 Broad Ave
Belle Vernon, PA 15012-1664

Phone

(724) 929-5774

Fax

(724) 929-9524

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Orthopedic & Sports Physical Therapy Associates, Inc.

  • Physical Therapist
  • Charleroi, PA
  • NPI 1689636581
  Medicare reassignment

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497783781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 BROAD AVE",
            "city": "BELLE VERNON",
            "state": "PA",
            "postal_code": "150121664",
            "telephone_number": "724-929-5774",
            "fax_number": "724-929-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 BROAD AVE",
            "city": "BELLE VERNON",
            "state": "PA",
            "postal_code": "150121664",
            "telephone_number": "724-929-5774",
            "fax_number": "724-929-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVITELLO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "PT010031L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015935850006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chito M. Crudo, M.D., P.C.
• Christopher D Chovan
• Anthony Paul Churak, DMD
• John M Cicchini, O.D.
• Lori Cicchini, O.D.
• Community Link Clinical Services
• Complete Health Chiromed
• James John Connolly, D.D.S.
• Julia Constantine, PA-C
• Chito M Crudo, MD

• Specialist in Belle Vernon, PA
• Providers in Belle Vernon, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.