DR. LEE MICHAEL CICCARELLI (M.D.) – Specialist, NPI 1417909029
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
360 GERIATRIC MEDICINE in PA
Provider Addresses for DR. LEE MICHAEL CICCARELLI (M.D.)
429 WASHINGTON BLVD
WILLIAMSPORT, PA 177015255
Phone: (570) 327-9480
Fax: (570) 327-9483
Type: Mailing
1251, Rural Avenue, Williamsport, Lycoming County, Pennsylvania, 17701, United States
WILLIAMSPORT, PA 177011697
Phone: (570) 327-9480
Fax: (570) 327-9483
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $140.
Total Amount is formed as General ($140) + Research ($0) + Ownership ($0) = $140.
Last reported payment date: 2023-09-19 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($120).
Total Amount
$140
General + Research + Ownership
Payments
2
Total payment records
General Amount
$140
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $120 |
| Astellas Pharma US Inc | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-06-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050615000633 | I | Geriatric Medicine | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1,574 | 110 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 965 | 156 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 683 | 81 | $0 |
| 82947 | Blood glucose (sugar) level | 445 | 70 | $0 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 228 | 58 | $0 |
Insurance plans in this area (ZIP 17701)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GERIATRIC MEDICINE | PA | 81002 | Urinalysis, manual test | 48 | 38 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | PA | |
| Family Practice | PA | |
| Emergency Medicine | PA | |
| Family Practice | PA | |
| Family Practice | PA | |
| Orthopedic Surgery | PA | |
| Physician Assistant | PA | |
| Internal Medicine | MA | |
| Physician Assistant | PA | |
| Orthopedic Surgery | PA |
Reviews
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