NPIMap

Individual provider Active NPI

Michael Samuel Cicchillo, MD

  • Vascular Surgery Physician
  • Columbia, SC
National Provider Identifier
1922033901
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
29174 Issued in SC
Practice address
3 Richland Medical Park Dr Ste 3320
Columbia, SC 29203-6849
Phone
(803) 434-7100
Fax
(803) 434-6889
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 29174 SC Primary
Vascular Surgery Physician 2086S0129X 35093033 OH

Addresses

Primary practice location

3 Richland Medical Park Dr Ste 3320
Columbia, SC 29203-6849

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (645) 228-6038

Other practice location 1

540 Parmalee Ave Ste 410
Youngstown, OH 44510-1605
Phone (330) 747-1106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230127000521 SC Practitioner - Vascular Surgery 8224167663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Northeastern Ohio University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

3 Richland Medical Park Dr
Suite 330
Columbia, SC 29203-6862
Phone (803) 434-4790

Hospital & facility affiliations

  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)21
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35093033OHMDVascular Surgery Physician
29174SCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Dec 18, 2025 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 18, 2025 Accepting new patients

Locations

1120 Roberts Branch Pkwy
#300
Columbia, SC 29203

3 Richland Medical Park Dr
Ste 330
Columbia, SC 29203
Phone (803) 434-7100

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: mcichillo629276@direct.ghs.myhfn.org

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 11

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1922033901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "645-228-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RICHLAND MEDICAL PARK DR STE 3320",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036849",
            "telephone_number": "803-434-7100",
            "fax_number": "803-434-6889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Parmalee Ave Ste 410",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445101605",
            "country_code": "US",
            "telephone_number": "330-747-1106",
            "fax_number": "330-747-0491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICCHILLO",
        "first_name": "MICHAEL",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "29174",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35093033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.