Individual provider Active NPI

Vincenzo Ciocca, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Bryn Mawr, PA
National Provider Identifier
1780867176
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
OS012362 Issued in PA
Practice address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone
(610) 526-3768
NPI assigned
Dec 10, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X OS012362 PA Primary

Addresses

Primary practice location

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010

Mailing address

PO Box 347490
Pittsburgh, PA 15251
Phone (888) 625-4685

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
I20080815000190 PA Practitioner - Pathology 1052486719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Philadelphia College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Pathology Associates, PCGroup PAC ID 9830179381, 11 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-2613

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 891-3301

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-4570

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-1152

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS012362PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Pathology Associates, PC CurrentSince Jul 17, 2008 Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 1

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 6

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": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780867176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 347490",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15251",
            "telephone_number": "888-625-4685",
            "fax_number": "302-731-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "19010",
            "telephone_number": "610-526-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIOCCA",
        "first_name": "VINCENZO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "OS012362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.