NPIMap

Individual provider Active NPI

Thomas G Chiccone, MD

  • Emergency Medicine Physician
  • Cambridge, MD
National Provider Identifier
1639123151
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0025287 Issued in MD
Practice address
300 Byrn St
Cambridge, MD 21613-1908
Phone
(410) 228-5511
Fax
(410) 228-1061
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0025287 MD Primary

Addresses

Primary practice location

300 Byrn St
Cambridge, MD 21613-1908

Mailing address

300 Byrn St
Cambridge, MD 21613-1908
Phone (410) 228-5511

Other identifiers 1

IdentifierTypeStateIssuer
066411100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0025287MDMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639123151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BYRN ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131908",
            "telephone_number": "410-228-5511",
            "fax_number": "410-228-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BYRN ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131908",
            "telephone_number": "410-228-5511",
            "fax_number": "410-228-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICCONE",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0025287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066411100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.