Individual provider Active NPI

Cristina Sifuentes-Ayala, PA-C, MS,RD,IBCLC

  • Physician Assistant
  • Port Neches, TX
National Provider Identifier
1285008136
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19088 Issued in TX
Practice address
2645 Nall St
Port Neches, TX 77651-4707
Phone
(409) 210-3336
NPI assigned
Nov 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT83900 TX
Physician Assistant 363A00000X PA19088 TX Primary

Addresses

Primary practice location

2645 Nall St
Port Neches, TX 77651-4707

Mailing address

2645 Nall St
Port Neches, TX 77651

Other practice location 1

2927 Nall St
Port Neches, TX 77651-5603
Phone (409) 210-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250514003580 TX Practitioner - Physician Assistant 7810415726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K Paul Gerstenberg, D O, P aGroup PAC ID 1254314511, 5 clinicians
Etx Medical Group, PLLCGroup PAC ID 8729494927, 14 clinicians

Practice addresses (Care Compare)

2927 Nall St
Port Neches, TX 77651-5603
Phone (409) 210-3336

4310 Dowlen Rd
Suite 16
Beaumont, TX 77706-6861
Phone (409) 299-4448

Hospital & facility affiliations

  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
DT83900TXMDRegistered Dietitian
PA19088TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Etx Medical Group, PLLC CurrentSince Aug 1, 2025 Accepting new patients
Ortho-Tek Inc Past Accepting new patients
Ortho-Tek Inc Past Accepting new patients

Locations

4310 Dowlen Rd
Ste 16
Beaumont, TX 77706
Phone (409) 299-4448

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 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": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1285008136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 NALL ST",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "77651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 NALL ST",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776514707",
            "telephone_number": "409-210-3336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2927 Nall St",
            "address_purpose": "LOCATION",
            "city": "Port Neches",
            "state": "TX",
            "postal_code": "776515603",
            "country_code": "US",
            "telephone_number": "409-210-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIFUENTES-AYALA",
        "first_name": "CRISTINA",
        "credential": "PA-C, MS,RD,IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT83900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Neches, TX

Sources for this page

Verify at the official NPI Registry.