NPIMap

Individual provider Active NPI

Alicia Marie Cisne, FNP

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1013482934
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10180113 Issued in MO
Practice address
225 Physicians Park Ste 400
Poplar Bluff, MO 63901-3923
Phone
(573) 727-5500
Fax
(573) 727-5599
NPI assigned
Oct 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10180113 MO Primary

Addresses

Primary practice location

225 Physicians Park Ste 400
Poplar Bluff, MO 63901-3923

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other names 1

  • Alicia Marie Dragon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181128000366 MO Practitioner - Nurse Practitioner 0648514992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians
Internal Medicine Associates of Southeast Missouri LLCGroup PAC ID 5991615072, 43 clinicians

Practice addresses (Care Compare)

1212 Saint Francis Dr
Dexter, MO 63841-2769
Phone (573) 614-3600

150 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

225 Physicians Park
Suite 400
Poplar Bluff, MO 63901-3923
Phone (573) 727-5500

225 Physicians Park Dr
Suite 400
Poplar Bluff, MO 63901-3923

24 S Mount Auburn Rd
Cape Girardeau, MO 63703-5049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10180113MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1212 Saint Francis Dr
Dexter, MO 63841
Phone (573) 614-3600

225 Physicians Park
Ste 400
Poplar Bluff, MO 63901
Phone (573) 785-7721

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

Interoperability endpoints

  • Direct secure messaging: acisne90297@surescripts.sfmc.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1013482934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 400",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013923",
            "telephone_number": "573-727-5500",
            "fax_number": "573-727-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNE",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-07",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F10180113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "DRAGON",
            "middle_name": "MARIE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.