Individual provider Active NPI

David Cicione

  • Physical Therapist
  • Ridgway, PA
National Provider Identifier
1760859540
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018526 Issued in PA
Practice address
104 Metoxet St
Ridgway, PA 15853-1932
Phone
(814) 788-5534
Fax
(814) 788-5549
NPI assigned
Aug 27, 2015
Last updated
Aug 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT018526 PA Primary

Addresses

Primary practice location

104 Metoxet St
Ridgway, PA 15853-1932

Mailing address

104 Metoxet St
Ridgway, PA 15853-1932
Phone (814) 788-5534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151117000836 PA Practitioner - Physical Therapist in Private Practice 5294045530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elk Regional Professional Group Inc Physical Therapist CurrentSince Sep 1, 2015 Accepting new patients
Elk Regional Professional Group, Inc. Current Accepting new patients

Locations

190 N Fraley St
Ste 1
Kane, PA 16735
Phone (814) 837-8955

104 Metoxet St
Ridgway, PA 15853
Phone (814) 788-5456

99 Hospital St
Ridgway, PA 15853
Phone (814) 788-5555

763 Johnsonburg Rd
Saint Marys, PA 15857
Phone (814) 788-8000

Organizations & group practices 2

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1760859540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 METOXET ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531932",
            "telephone_number": "814-788-5534",
            "fax_number": "814-788-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 METOXET ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531932",
            "telephone_number": "814-788-5534",
            "fax_number": "814-788-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICIONE",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgway, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.