Kirk Dominic Cianciolo, D.O

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

OS0004645 Issued in FL

Practice address

12464 Indian Rocks Rd
Largo, FL 33774

Phone

(727) 596-5446

Fax

(727) 593-0002

NPI assigned

Aug 30, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Houston Hospitals Inc

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  NPD
• Monument Health Rapid City Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  NPD
• Genesiscare USA of Florida LLC

  • Urology Physician
  • Venice, FL
  • NPI 1316127152
  NPD (past)
• Cor Healthcare Medical Associates

  • Internal Medicine Physician
  • Torrance, CA
  • NPI 1699864215
  NPD (past)
• Pennyrile Urology PSC

  • Urology Physician
  • Hopkinsville, KY
  • NPI 1992729529
  NPD (past)

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1780933127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 RIVIERA DUNES WAY",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342217127",
            "telephone_number": "727-798-2299",
            "fax_number": "727-593-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12464 INDIAN ROCKS RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33774",
            "telephone_number": "727-596-5446",
            "fax_number": "727-593-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 High St Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422406300",
            "country_code": "US",
            "telephone_number": "270-886-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIANCIOLO",
        "first_name": "KIRK",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-30",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "03552",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "OS0004645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3972115",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "211521",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017137800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "JTNOA",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy T. Christman, MD
• Christopher J. Bonham, D.M.D., P.a.
• Karyn Chucri
• Patricia Chun, D.O.
• Quanesha Church
• Nathaniel Marcus Cintron, DO
• Devan Layne Cirino, MSN, APRN, FNP-C
• CJL Anesthesia LLC
• Brandon Connor Clair, MD
• Bryan Michael Clark, DO

• Urology Physician in Largo, FL
• Providers in Largo, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.