SEAN J CUNNINGHAM PA-C
NPI 1255348470
Physician Assistant in Erie, PA

Active since August 01, 2006PECOS EnrolledAccepts Medicare Assignment
79.55/100
CMS Quality Rating
100 PEACH ST STE 400, ERIE, PA 16507(814) 877-9100(814) 454-8470 Get Directions Write a Review

NPPES record last updated: April 11, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 11, 2023, Aug 10, 2021, Mar 26, 2021 and 2 more (5 updates tracked since 2016).

About Sean J Cunningham Pa-c NPPES

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

SEAN J CUNNINGHAM PA-C (NPI 1255348470) is an individual physician assistant in Erie, Pennsylvania, licensed in Pennsylvania (MA052590) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1255348470
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSEAN J CUNNINGHAMCredential: PA-C
Location Address100 PEACH ST STE 400Erie, PA 16507-1423
Mailing Address100 Peach St Ste 400Erie, PA 16507-1423 · (814) 877-9100 · Fax (814) 454-8470
Fax(814) 454-8470
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateAugust 1, 2006
Last NPPES UpdateApril 11, 20235 updates tracked since enumeration
NPPES CertifiedApril 11, 2023
NPI 1255348470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in PA · MA052590
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

100 PEACH ST STE 400, Erie, PA 16507

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

Sean J Cunningham Pa-c 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 ID1456355346
PECOS Enrollment IDI20060929000165, I20200616000030
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 5

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.

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
238 services28 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
86 services54 patients
Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose J7323
Hyaluronan or Euflexxa is a substance similar to a natural substance in your joints. It's injected into the joint space to treat pain from osteoarthritis, especially in the knee. It helps to lubricate the joint, reducing pain and improving mobility.
46 services17 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.
30 services30 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
14 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16507 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
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.

79.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.36
Promoting Interoperability100
Improvement Activities40
Cost67.48

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.

Student in an Organized Health Care Education/Training Program
100 PEACH ST STE 400
ERIE, PA 16507
Physician Assistant
100 PEACH ST STE 400, SUITE 400
ERIE, PA 16507
Orthopaedic Surgery
100 PEACH ST STE 400, SUITE 400
ERIE, PA 16507
Physician Assistant
100 PEACH ST STE 400, SUITE 400
ERIE, PA 16507
Orthopaedic Surgery
100 PEACH ST STE 400, SUITE 101
ERIE, PA 16507
Orthopaedic Surgery (Hand Surgery)
100 PEACH ST STE 400
ERIE, PA 16507
Physician Assistant
100 PEACH ST STE 400, SUITE 400
ERIE, PA 16507
Physician Assistant
100 PEACH ST STE 400, SUITE 400
ERIE, PA 16507

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 Sean Cunningham's NPI number?

The NPI number for Sean Cunningham is 1255348470. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Sean Cunningham located?

Sean Cunningham practices at 100 Peach St Ste 400, Erie, PA 16507. The listed phone number is (814) 877-9100.

What is Sean Cunningham's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Sean Cunningham enrolled in Medicare?

Yes. Sean Cunningham 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.

When was this NPI record last updated?

The NPPES record for Sean Cunningham was last updated on April 11, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.