Individual provider Active NPI

Michael Christopher Ciccotti, M.D.

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1528487436
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD474669 Issued in PA
Practice address
9501 Roosevelt Blvd FL 4
Philadelphia, PA 19114-1019
Phone
(800) 321-9999
NPI assigned
Apr 8, 2014
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 25MA11173500 NJ
Orthopaedic Surgery Physician 207X00000X 036153327 IL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036153327 IL
Orthopaedic Surgery Physician 207X00000X MD474669 PA Primary

Addresses

Primary practice location

9501 Roosevelt Blvd FL 4
Philadelphia, PA 19114-1019

Mailing address

833 Chestnut St Ste 520
Philadelphia, PA 19107-4430
Phone (609) 677-7003

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
I20210729000212 PA Practitioner - Orthopedic Surgery 7315164241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

925 Chestnut St
FL 5
Philadelphia, PA 19107-4206
Phone (267) 339-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
79.04
Promoting interoperability
99
Improvement activities
40
Cost
82.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11173500NJMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Orthopaedic Associates II LLC Orthopaedic Surgery CurrentSince Sep 13, 2021 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Orthopaedic Surgery CurrentSince Sep 13, 2021 Accepting new patients
Rothman Orthopaedics of New Jersey, LLC Orthopaedic Surgery Past Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053

3300 Tillman Dr
Fl 2
Bensalem, PA 19020
Phone (215) 637-1800

101 Pheasant Run
Newtown, PA 18940

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

9501 Roosevelt Blvd
Fl 4
Philadelphia, PA 19114
Phone (215) 992-4975

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.

Hospital & facility affiliations 2

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1528487436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 520",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074430",
            "telephone_number": "609-677-7003",
            "fax_number": "267-339-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141019",
            "telephone_number": "800-321-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCOTTI",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA11173500",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036153327",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036153327",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD474669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.