Active NPI
Sebastian James Ciancio, M.D
- Urology Physician
- Danville, IL
National Provider Identifier
1891893525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 036-116977
- Practice address
- 707 N Logan Ave
Danville, IL 61832-4360 - Phone
- (217) 477-4766
- Fax
- (217) 477-4752
- NPI assigned
- Sep 20, 2006
- Last updated
- Jan 12, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME82330 | FL | |
| Urology Physician | 208800000X | 036-116977 | IL | Primary |
Addresses
Primary practice location
707 N Logan Ave
Danville, IL 61832-4360
Mailing address
707 N Logan Ave
Danville, IL 61832-4360
Phone (217) 477-4766
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 771911 | Other | HEALTHLINK | |
| 036116977 | Medicaid | IL | |
| 2008515830A | Medicaid | IN | |
| 292136 | Other | IL | PERSONAL CARE COVENTRY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME82330 | FL | MD | Urology Physician |
| 036-116977 | IL | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421020800000",
"number": "1891893525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 N LOGAN AVE",
"city": "DANVILLE",
"state": "IL",
"postal_code": "618324360",
"telephone_number": "217-477-4766",
"fax_number": "217-477-4752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 N LOGAN AVE",
"city": "DANVILLE",
"state": "IL",
"postal_code": "618324360",
"telephone_number": "217-477-4766",
"fax_number": "217-477-4752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIANCIO",
"first_name": "SEBASTIAN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2015-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME82330",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036-116977",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "771911",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036116977",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2008515830A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CARE COVENTRY",
"identifier": "292136",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Danville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.