Dr. Lee Michael Ciccarelli
Specialist

Address: 1251 Rural Ave, Williamsport, PA 17701-1697
Phone: 5703279480

Dr. Lee Michael Ciccarelli (NPI# 1417909029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1417909029
Entity Type Individual
Full Name Dr. Lee Michael Ciccarelli
Credential M.D.
Gender Male
Practice Address 1251 Rural Ave
Williamsport
PA 17701-1697
Practice Telephone 5703279480
Practice Fax Number 5703279483
Mailing Address 1251 Rural Ave
Williamsport
PA 17701-1697
Mailing Telephone 5703279480
Mailing Fax Number 5703279483
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2006-05-16
Last Update Date 2010-01-12

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 173000000X Legal Medicine Other Service Providers MD022616E PA
Yes 174400000X Specialist Other Service Providers MD022616E PA

Physician Overview

NPI 1417909029
PAC ID by PECOS 6305880899
Professional Enrollment ID I20050615000633
Full Name Lee Michael Ciccarelli
Phone Number 5703279480
Gender M
Credential MD
Medical School BOWMAN GRAY SCHOOL OF MEDICINE OF WAKE FOREST UNIVERSITY
Graduation Year 1978
Primary Specialty GERIATRIC MEDICINE
Secondary Specialties INTERNAL MEDICINE
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
390045 WILLIAMSPORT REGIONAL MEDICAL CENTER
390006 GEISINGER MEDICAL CENTER

Office Location

Street Address 1251 RURAL AVE
City WILLIAMSPORT
State PA
Zip Code 17701-1697

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891106746 Genesis Eldercare Rehabilitation Services, LLC Clinic/Center 1251 Rural Ave, C/o Roseview Court, Williamsport, PA 17701 2014-05-14
1669747218 Nancy L. Krause Occupational Therapy Assistant 1251 Rural Ave, Williamsport, PA 17701-1697 2012-03-15
1699097469 Barbara Chesney Physical Therapy Assistant 1251 Rural Ave, Williamsport, PA 17701-1697 2010-02-22
1134453889 Erica L. Derrick Occupational Therapist 1251 Rural Ave, Williamsport, PA 17701-1697 2009-09-29
1841472164 Rose View Manor LLC Assisted Living Facility 1251 Rural Ave, Williamsport, PA 17701-1697 2007-11-28
1497879530 Mary Patricia Sherman Occupational Therapist 1251 Rural Ave, Williamsport, PA 17701-1697 2007-03-16
1902842305 Rose View Manor, Inc. Assisted Living Facility 1251 Rural Ave, Williamsport, PA 17701-1697 2006-06-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528551231 Mark Hampton Chiropractic Inc. Durable Medical Equipment & Medical Supplies 1111 East 3rd Street, Williamsport, PA 17701 2018-06-08
1548710882 Central Pennsylvania Rehabilitation Medicine, Inc Physical Medicine & Rehabilitation 460 River Ave Ste 1, Williamsport, PA 17701 2016-10-11
1376096784 Christine Kessler Physician Assistant One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 2016-08-02
1629440276 Matthew Ray Rebuck Specialist/Technologist 220 N Reach Rd, Williamsport, PA 17701 2015-10-22
1508237223 Neihl Williamson Physician Assistant 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 2015-10-08
1568872521 Kiersten Manno Behavior Analyst 709 Cambel St, Williamsport, PA 17701 2014-04-30
1558708503 Joanna M Kraynak Family Medicine 699 Rural Avenue, Sublevel 1, Williamsport, PA 17701 2013-05-31
1578802864 Joseph L Costa Nurse Practitioner 460 River Ave, Williamsport, PA 17701 2013-02-06
1619243078 Chelsea Lynn Laurenson Physical Therapy Assistant 1528 Randall Circle, Williamsport, PA 17701 2012-03-29
1104051671 Jessie S. Hartman Counselor Diakon Family Life Services, 435 W. Fourth Street, Williamsport, PA 17701 2009-05-27
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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407001126 Pickaway Health Services Specialist 9391 State Route 56, Williamsport, OH 43164-9743 2008-11-21
1164640736 Fred R Amsler Jr. Specialist 1738 E 3rd St, #316, Williamsport, PA 17701-3870 2007-04-20
1114989993 Able Therapy Services, Inc Specialist 2605 Reach Rd, Williamsport, PA 17701-4181 2006-04-05
1710289533 Lisa M Wooten Specialist 520 W 4th St, Williamsport, PA 17701-6038 2010-11-30
1992857395 Lycoming Neurosurgical Associates, Inc Specialist 904 Campbell St, Suite 104, Williamsport, PA 17701-3166 2007-01-17
1184687584 Jonathan Whitney Sakowski Specialist 2605 Reach Rd, Ste A, Williamsport, PA 17701-4181 2006-04-08
1528033651 Rodwan K Rajjoub Specialist 904 Campbell St, Suite 104, Williamsport, PA 17701-3154 2006-02-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1740758168 William Whitaker Specialist 1115 E Sanger St, Philadelphia, PA 19124-1130 2018-11-02
1619442464 Eric Eshbaugh Specialist 806 Rockville Rd, South Fork, PA 15956-3503 2018-10-08
1689158081 Chelsea Wanamaker Specialist 2909 Route 100 # 110, Orefield, PA 18069-2951 2018-09-20
1538643028 Meghan Emily Heubel Specialist 2909 Pa-100 #100, Orefield, PA 18069 2018-09-20
1437632791 Christa Marie Flood Specialist 427 Township Line Rd, Elkins Park, PA 19027-2202 2018-09-12
1447731716 Christine Ellen Stewart Specialist 1999 Sproul Rd Ste 11, Broomall, PA 19008-3508 2018-08-24
1225528185 Bucks County Vein, LLC Specialist 1205 Langhorne-newtown Rd Suite 106, Langhorne, PA 19047 2018-05-16
1235628751 Healthy Connections of Pennsylvania Specialist 147 Red Oak Dr, Lincoln Univ, PA 19352-8939 2018-05-10
1902395536 Ran Barzilay Specialist 3440 Market St, Suite 200, Philadelphia, PA 19104 2018-05-09
1255830410 Robyn Marie Barbosa Specialist 560 Lafayette Ave, Palmerton, PA 18071-1621 2018-02-02
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Competitor

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City WILLIAMSPORT
Zip Code 17701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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