TONI SICENICA MD
NPI 1235123159
Internal Medicine - Pulmonary Disease in Jefferson Hills, PA

Q: What is Toni Sicenica's NPI number?

The NPI number for Toni Sicenica is 1235123159. It was assigned to this individual provider in the NPPES registry on September 7, 2005.

Q: What is Toni Sicenica's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Toni Sicenica was last updated on April 14, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 07, 2005PECOS EnrolledAccepts Medicare Assignment

52.72/100

CMS Quality Rating

1200 BROOKS LN, SUITE 130, JEFFERSON HILLS, PA 15025(412) 469-3600(412) 469-3630 Get Directions Write a Review

NPPES record last updated: April 14, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Toni Sicenica Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TONI SICENICA MD (NPI 1235123159) is an individual pulmonary disease provider in Jefferson Hills, Pennsylvania, licensed in Pennsylvania (MD073848L) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Weirton Medical Center, Inc, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1235123159

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameTONI SICENICACredential: MD

Location Address1200 BROOKS LN, SUITE 130Jefferson Hills, PA 15025-3747

Mailing Address1019 Summerset DrPittsburgh, PA 15217-2550 · (412) 521-7375

Phone(412) 469-3600

Fax(412) 469-3630

Sole ProprietorNo

Medical School CMSOtherGraduated 1987

Enumeration DateSeptember 7, 2005

Last NPPES UpdateApril 14, 2010

✔ NPI 1235123159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in PA · MD073848L

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

1200 BROOKS LN, Jefferson Hills, PA 15025

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Other Identifiers 3

Medicare UPINH61419

Medicare ID-Type Unspecified058037PA

Medicaid001896215PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Toni Sicenica Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810961927

PECOS Enrollment IDI20150425000211

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

731 services147 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

177 services72 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

123 services90 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

99 services83 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

93 services79 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

57 services54 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Weirton Medical Center, Inc

Acute Care Hospitals · Weirton, WV

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number510023

Location601 Colliers WayWeirton, WV 26062 · Hancock County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

52.72/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

72.85

Improvement Activities

Cost

55.1

Referred Medical Equipment & Supplies CMS DME claims 22

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

6 suppliers26 claims26 services$38.84 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

3 suppliers19 claims38 services$1.42 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

4 suppliers16 claims17 services$92.00 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers22 claims54 services$35.42 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

4 suppliers16 claims91 services$20.30 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

3 suppliers16 claims54 services$12.97 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

7 suppliers23 claims23 services$54.15 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

7 suppliers28 claims28 services$18.47 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

7 suppliers55 claims254 services$2.16 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

6 suppliers18 claims18 services$10.47 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

6 suppliers109 claims111 services$14.68 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

3 suppliers20 claims21 services$44.49 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers23 claims23 services$906.54 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

2 suppliers15 claims16 services$91.00 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

2 suppliers22 claims23 services$13.97 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

5 suppliers47 claims60 services$5.39 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers21 claims26 services$34.75 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

10 suppliers241 claims244 services$83.24 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers76 claims76 services$32.66 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

12 suppliers83 claims24,978 services$0.03 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

4 suppliers17 claims905 services$0.16 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

9 suppliers90 claims90 services$24.05 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID J. STAPOR M.D.

Orthopaedic Surgery

1200 BROOKS LN, SUITE 240
CLAIRTON, PA 15025

Allegheny County (412) 469-1660

SOUTH HILLS GASTROENTEROLOGY ASSOCIATES LLC

Internal Medicine (Gastroenterology)

1200 BROOKS LN, STE G10
CLAIRTON, PA 15025

Allegheny County (412) 469-5914

ALLISON MORGAN PA-C

Physician Assistant

1200 BROOKS LN, SUITE 290
JEFFERSON HILLS, PA 15025

Allegheny County (412) 729-1500

LANA P BLINER NP-C

Nurse Practitioner

1200 BROOKS LN, SUITE NUMBER 285
CLAIRTON, PA 15025

Allegheny County (412) 449-6956

PAUL DAVID LAMAN JR. MD

Internal Medicine (Critical Care Medicine)

1200 BROOKS LN, SUITE 130
JEFFERSON HILLS, PA 15025

Allegheny County (412) 469-3600

DR. NUPUR DASHOTTAR M.D.

Family Medicine

1200 BROOKS LN, SUITE 290
JEFFERSON HILLS, PA 15025

Allegheny County (412) 729-1500

KATIE F DIPASQUALE PA-C

Physician Assistant

1200 BROOKS LN, SUITE 290
JEFFERSON HILLS, PA 15025

Allegheny County (412) 729-1500

CENTER POINTE SLEEP ASSOCIATES, LLC

Clinic/Center (Sleep Disorder Diagnostic)

1200 BROOKS LN, SUITE 140
JEFFERSON HILLS, PA 15025

Allegheny County (724) 941-6595

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Toni Sicenica's NPI number?

The NPI number for Toni Sicenica is 1235123159. It was assigned to this individual provider in the NPPES registry on September 7, 2005.

Where is Toni Sicenica located?

Toni Sicenica practices at 1200 Brooks Ln Suite 130, Jefferson Hills, PA 15025. The listed phone number is (412) 469-3600.

What is Toni Sicenica's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Toni Sicenica enrolled in Medicare?

Yes. Toni Sicenica is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Toni Sicenica affiliated with any hospitals?

According to CMS data, Toni Sicenica is affiliated with Weirton Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Toni Sicenica was last updated on April 14, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.