NPIMap

Individual provider Active NPI

Aura Maria Cisneros, D.M.D

  • General Practice Dentistry
  • Ruskin, FL
National Provider Identifier
1356346340
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN19315 Issued in FL
Practice address
2814 14TH Ave SE
Ruskin Health Center
Ruskin, FL 33570
Phone
(813) 349-7834
Fax
(813) 349-7861
NPI assigned
Jun 16, 2005
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN19315 FL Primary
General Practice Dentistry 1223G0001X 2486 PR

Addresses

Primary practice location

2814 14TH Ave SE
Ruskin Health Center
Ruskin, FL 33570

Mailing address

13110 Elk Mountain Dr
Riverview, FL 33579-7182
Phone (813) 349-7568

Other identifiers 4

IdentifierTypeStateIssuer
42473OtherPRINSURANCE COMPANY SSS
043023OtherPRINS. CO. CRUZ AZUL
206476OtherPRINS. CO. UTI
9790040OtherPRINS. CO. HUMANA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160523000519 FL Order and Referring Only - DentistPractitioner - Dentist 7113216623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN19315FLMDGeneral Practice Dentistry
2486PRMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aura.cisneros@suncoastchc.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tom Lee Community Health CenterDover, FL, CCN 101917 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jan 1, 2022
Jan 1, 2022
Jan 1, 2022
Brandon Community Health CenterBrandon, FL, CCN 101169 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Jan 1, 2022
Jan 1, 2022
Jan 1, 2022
Thonotosassa Community Health CenterThonotosassa, FL, CCN 681100 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Jan 1, 2022
Jan 1, 2022
Suncoast Community Health Centers IncRuskin, FL, CCN C11077 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control		 Mar 17, 2025
Mar 17, 2025
Mar 17, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1356346340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13110 ELK MOUNTAIN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797182",
            "telephone_number": "813-349-7568",
            "fax_number": "813-349-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 14TH AVE SE",
            "address_2": "RUSKIN HEALTH CENTER",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "33570",
            "telephone_number": "813-349-7834",
            "fax_number": "813-349-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "AURA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19315",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2486",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE COMPANY SSS",
            "identifier": "42473",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INS. CO. CRUZ AZUL",
            "identifier": "043023",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INS. CO. UTI",
            "identifier": "206476",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INS. CO. HUMANA",
            "identifier": "9790040",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruskin, FL

Sources for this page

Verify at the official NPI Registry.