Individual provider Active NPI

Tracy Janette Cisneros, PT, DPT, CLT

  • Physical Therapist
  • Waco, TX
National Provider Identifier
1053924340
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1294772 Issued in TX
Practice address
50 Hillcrest Medical Blvd Ste 102
Waco, TX 76712-8953
Phone
(254) 202-7900
Fax
(254) 202-7949
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1294772 TX Primary

Addresses

Primary practice location

50 Hillcrest Medical Blvd Ste 102
Waco, TX 76712-8953

Mailing address

PO Box 848491
Dallas, TX 75284-8491
Phone (254) 202-9330

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tracy.cisneros@bswhealth.org Direct
Direct Messaging Address tcisneros295887@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201123002536 TX Practitioner - Physical Therapist in Private Practice 5294146262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Physician ServicesGroup PAC ID 1153304456, 114 clinicians

Practice addresses (Care Compare)

50 Hillcrest Medical Blvd
Waco, TX 76712-8953

50 Hillcrest Medical Blvd
Suite 206
Waco, TX 76712-8954
Phone (254) 202-7950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Oct 26, 2020 Accepting new patients
Scott & White Clinic Current Accepting new patients
Hillcrest Physician Services CurrentSince Oct 26, 2020 Accepting new patients
Scott and White Clinic CurrentSince Oct 26, 2020 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

5701 Airport Rd
#200
Temple, TX 76502
Phone (254) 215-9790

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

50 Hillcrest Medical Blvd
Ste 102
Waco, TX 76712
Phone (254) 202-7215

50 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-7300

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1053924340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848491",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848491",
            "telephone_number": "254-202-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 HILLCREST MEDICAL BLVD STE 102",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128953",
            "telephone_number": "254-202-7900",
            "fax_number": "254-202-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "TRACY",
        "middle_name": "JANETTE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1294772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.cisneros@bswhealth.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "50 Hillcrest Medical Blvd Ste 102",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcisneros295887@direct.sw.org",
            "affiliation": "N",
            "address_1": "50 Hillcrest Medical Blvd Ste 102",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.