Jose Gomez Cisneros, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

50002 Issued in AZ

Practice address

3140 N 35TH Ave Ste 7
Phoenix, AZ 85017-5270

Phone

(602) 353-6656

Fax

(602) 442-2065

NPI assigned

Aug 6, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Clinica Medica del Sol, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023155991
  Medicare reassignment NPD
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)
• Jose a Garcia Vicario MD CSP

  • Specialist
  • Ponce, PR
  • NPI 1750587762
  NPD (past)

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1023249174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 N 35TH AVE STE 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175270",
            "telephone_number": "023-536-6566",
            "fax_number": "602-442-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 N 35TH AVE STE 7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175270",
            "telephone_number": "602-353-6656",
            "fax_number": "602-442-2065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3102 E Indian School Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850166872",
            "country_code": "US",
            "telephone_number": "602-353-6656",
            "fax_number": "602-442-2065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3602 W Thomas Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850194442",
            "country_code": "US",
            "telephone_number": "602-296-4488",
            "fax_number": "800-284-6891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "JOSE",
        "middle_name": "GOMEZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "50002",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "50002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Cirullo, MD
• Dorcas Sue Ciskowski, PT
• Mariana Cisneros Amparan
• Keeley Cisneros Siggins, NP-C
• Guadalupe Cisneros
• Stephanie Cites, RDN
• Citi Care LLC
• Citrus Primary and Wellness LLC
• City Center Chiropractic
• City Help, Inc.

• General Practice Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.