Cicely Moreno, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

4301509637 Issued in MI

Practice address

4 Longmeadow Village Dr
Niles, MI 49120-7809

Phone

(269) 684-6000

NPI assigned

Jan 20, 2017

Last updated

Jan 16, 2026By the provider in NPPES

Sex

Female

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 IN, MI2 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

Specialty

Family PracticeAlso: Addiction Medicine

Education

Indiana University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmoreno2737431@direct.trinity-health.org
• Direct secure messaging: cmoreno904468@epic00.shdirect.org
• Direct secure messaging: cmoreno990316@direct.hfhs.org

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.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment Care Compare group NPD
• Nwi Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Munster, IN
  • NPI 1043596703

  Family Medicine

  Medicare reassignment NPD
• Sacred Heart Rehabilitation Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Richmond, MI
  • NPI 1750363305
  Medicare reassignment
• Midwest Express Care, Inc

  • Urgent Care Clinic/Center
  • Schererville, IN
  • NPI 1942642848
  Medicare reassignment
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD
• Sacred Heart Rehabilitation Center, Inc

  • Community/Behavioral Health Agency
  • Flint, MI
  • NPI 1104959493
  NPD
• Sacred Heart Rehabilitation Center, Inc

  • Community/Behavioral Health Agency
  • Berrien Center, MI
  • NPI 1548670391
  NPD
• Lakeland Medical Practices

  dba Lakeland Family Care of Niles

  • Clinic/Center
  • Niles, MI
  • NPI 1629397534
  NPD (past)
• Lakeland Medical Practices

  dba Lakeland Family Medicine

  • Clinic/Center
  • Niles, MI
  • NPI 1801116785
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • General Acute Care Hospital
  • Watervliet, MI
  • NPI 1700994845
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1285171827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONGMEADOW VILLAGE DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207809",
            "telephone_number": "269-684-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LONGMEADOW VILLAGE DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207809",
            "telephone_number": "269-684-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6418 Deans Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Berrien Center",
            "state": "MI",
            "postal_code": "491028713",
            "country_code": "US",
            "telephone_number": "269-815-5500",
            "fax_number": "269-815-5373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42 N Saint Joseph Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491202203",
            "country_code": "US",
            "telephone_number": "269-687-1126",
            "fax_number": "269-687-1127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "133 W Main St",
            "address_purpose": "LOCATION",
            "city": "Benton Harbor",
            "state": "MI",
            "postal_code": "490223607",
            "country_code": "US",
            "telephone_number": "269-408-2258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1234 Napier Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "269-982-4941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5043 E 81st Ave",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464105912",
            "country_code": "US",
            "telephone_number": "219-707-5276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "CICELY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01083223A",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4301509637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey E Milner
• Emily A Mitchell, D.O.
• Toby Andrew Mitchell, D.C.
• Dylan Mondschein
• Crystal Ashley Monnin, LLMSW
• Lee Morris
• Jessica Morse, COMMUNITY HEALTH WOR
• Saundra L Mortenson, LCSW
• Charles Andrew Mosimbwa, M.D.
• Estelle Gladys Moss

• Addiction Medicine (Family Medicine) Physician in Niles, MI
• Providers in Niles, MI by specialty
• Addiction Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.
• 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.