Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Phillip Martin Cicco, NP

Individual provider Nurse Practitioner · NPI 1679987143

Phillip Martin Cicco, NP is a Nurse Practitioner in Syracuse, New York. Qualified in 2014, 12 years ago. Practices with St Josephs Medical PC, a 385-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2014
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

736 Irving Ave
Syracuse, NY 13210-1687
Phone: (315) 470-7111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 50 Leroy St, Potsdam, NY 13676-1786 — (315) 265-3300

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 338748 (NY)

Record details

NPI number1679987143
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJune 12, 2014
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice St Josephs Medical Pc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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