Individual provider Active NPI

Elizabeth Siacunco, MD

  • Emergency Medicine Physician
  • Rancho Mirage, CA
National Provider Identifier
1104355064
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T2982 Issued in 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
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A159671 CA
Emergency Medicine Physician 207P00000X T2982 TX Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210805003041 CA Practitioner - Emergency Medicine 0941604482 Reassigns benefits to 4 organizations
I20210831001240 TX Practitioner - Emergency Medicine 0941604482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
89.56
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A159671CAMDEmergency Medicine Physician
T2982TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chino Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Observation Services of Wichita Falls LLC Emergency Medicine CurrentSince Mar 21, 2025 Accepting new patients
Bakersfield Family Medical Group Inc CurrentSince Apr 22, 2021 Accepting new patients
Eisenhower Medical Center Current Accepting new patients
United Regional Health Care System Inc Current Accepting new patients
Titanium Emergency Group LLP Emergency Medicine CurrentSince Aug 15, 2021 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 11, 2025 Accepting new patients
Montclair Emergency Medical Associates Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 11, 2025 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

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

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

Interoperability endpoints

  • Direct secure messaging: elizabeth.siacunco.p1@direct.bfmc.nextgenshare.com
  • Direct secure messaging: esiacunco62430@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

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

Hospital & facility affiliations 1

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1104355064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-340-3911",
            "fax_number": "760-773-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-340-3911",
            "fax_number": "760-773-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIACUNCO",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A159671",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T2982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.