Elizabeth Siacunco, MD
Individual provider Active NPI Emergency Medicine Physician · Rancho Mirage, CA
NPI 1104355064 · NPPES record last updated Aug 11, 2025
Key facts
- NPI
- 1104355064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- T2982 (TX)
- Practice address
- 39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221 - Phone
- (760) 340-3911
- Fax
- (760) 773-1481
- NPI assigned
- Jun 5, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of Arizona College of Medicine, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1600 11TH St
Wichita Falls, TX 76301-4388
Hospital & facility affiliations
- United Regional Health Care System
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 89.56
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210805003041 | CA | Practitioner - Emergency Medicine | 0941604482 | Reassigns benefits to 4 organizations |
| I20210831001240 | TX | Practitioner - Emergency Medicine | 0941604482 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A159671 | CA | MD | Emergency Medicine Physician |
| T2982 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eisenhower Medical Center | Current | Accepting new patients | |
| Titanium Emergency Group LLP | Emergency Medicine | Current |
Accepting new patients |
| United Regional Health Care System Inc | Current | Accepting new patients | |
| Chino Emergency Medical Associates, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Observation Services of Wichita Falls LLC | Emergency Medicine | Current |
Accepting new patients |
| Eisenhower Medical Center | Current |
Accepting new patients | |
| Eisenhower Medical Center | Current |
Accepting new patients | |
| Montclair Emergency Medical Associates | Emergency Medicine | Current |
Accepting new patients |
| Bakersfield Family Medical Group Inc | Current |
Accepting new patients | |
| Coastal Communities Physician Network, Inc. | Past | Accepting new patients |
Locations
4580 California Ave
Bakersfield, CA 93309
Phone (661) 327-4411
5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600
5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111
72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999
39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911
39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813
39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053
1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000
Interoperability endpoints
- esiacunco62430@unitedregional.medalliesdirect.net
- https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- elizabeth.siacunco.p1@direct.bfmc.nextgenshare.com
- https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A159671 | CA | |
| Emergency Medicine Physician | 207P00000X | T2982 | TX | Yes |
Addresses
Primary practice location
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Mailing address
39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 340-3911
Other providers in Rancho Mirage, CA
- Jared C. Shipley
- Barbara S. Shore
- Peter Charles Shorts
- Scott A Shuford
- Jenan Nadim Shukry
- Nicole Siacunco
- Koushan Siami-Namini
- Sierra Psychological Associates, Inc.
- Sepehr Silani
- Jesus Silva
All providers in Rancho Mirage, CA · Emergency Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.