Individual provider Active NPI

Michael C Ciccarone, DNP, FNP-BC

  • Family Nurse Practitioner
  • Venice, FL
National Provider Identifier
1881264992
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11017354 Issued in FL
Practice address
1101 Tamiami TRL S Ste 108
Venice, FL 34285-4133
Phone
(941) 488-2332
NPI assigned
Jun 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11017354 FL Primary

Addresses

Primary practice location

1101 Tamiami TRL S Ste 108
Venice, FL 34285-4133

Mailing address

1101 Tamiami TRL S Ste 108
Venice, FL 34285-4133
Phone (941) 488-2332

Other practice location 1

164 Picadilly Ln
Gray, TN 37615-3231
Phone (423) 617-2471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629001580 FL Practitioner - Nurse Practitioner 1850798463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paradise Family Healthcare IncGroup PAC ID 5890737373, 2 clinicians
Empath Therapies LLCGroup PAC ID 5496144529, 108 clinicians

Practice addresses (Care Compare)

229 Nokomis Ave S
Venice, FL 34285-2319
Phone (941) 488-2332

3600 William Penn Way
Venice, FL 34293-5236
Phone (941) 483-0746

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11017354FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Family Healthcare Inc Single Specialty CurrentSince Jan 21, 2023 Accepting new patients

Locations

229 Nokomis Ave S
Venice, FL 34285
Phone (941) 488-2332

1101 Tamiami Trl S
Ste 108
Venice, FL 34285
Phone (941) 488-2332

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1881264992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 TAMIAMI TRL S STE 108",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342854133",
            "telephone_number": "941-488-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TAMIAMI TRL S STE 108",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342854133",
            "telephone_number": "941-488-2332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Picadilly Ln",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376153231",
            "country_code": "US",
            "telephone_number": "423-617-2471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICCARONE",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11017354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.