Luis Sierra-Nieves, P.A.C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02353 Issued in TX

Practice address

710 E Pioneer Pkwy
Grand Prairie, TX 75051-4958

Phone

(972) 262-8211

Fax

(972) 226-2831

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bruce E. Wardle', D.O, P.a.

  dba oakcliff medical treatment clinic

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1386765162
  NPD
• 303 Medical Clinic, P.a.

  • Family Medicine Physician
  • Grand Prarie, TX
  • NPI 1437270220
  NPD (past)
• O'Connor Medical Center, P.a.

  • Family Medicine Physician
  • Irving, TX
  • NPI 1174644496
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1336367952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E PIONEER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514958",
            "telephone_number": "972-262-8211",
            "fax_number": "972-226-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E PIONEER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514958",
            "telephone_number": "972-262-8211",
            "fax_number": "972-226-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA-NIEVES",
        "first_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mannah John Siafa, RN
• Siddig Izzeldin Siddig
• Adila Nighat Siddiqi, D.O.
• Shawn Siddiqi
• Sameen Rab Siddiqui
• Signage Health Care Services, Inc (Elder Choice Health Care Services)
• Lyvonne Greene- Simington, HCS-PROVIDER
• Jason Simmons, LVN
• Simon Ogbeide D/B/a Orchard Medical Supply
• Christine Simon, DPT

• Physician Assistant in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.