Individual provider Active NPI

Michael Joshua Cisco, MD

  • Pediatric Critical Care Medicine Physician
  • Palo Alto, CA
National Provider Identifier
1457486300
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
A87399 Issued in CA
Practice address
725 Welch Rd
Packard Childrens Hospital at Stanford
Palo Alto, CA 94304-1601
Phone
(650) 723-7913
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X A87399 CA Primary

Addresses

Primary practice location

725 Welch Rd
Packard Childrens Hospital at Stanford
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Packard Childrens Hospital at Stanford
Palo Alto, CA 94304-1601
Phone (650) 723-7913

Other identifiers 1

IdentifierTypeStateIssuer
00A873990MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040901001503 CA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 4284609132 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists)
Education
University of North Carolina at Chapel Hill School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCSF Pediatrics AssociatesGroup PAC ID 6204749112, 102 clinicians

Practice addresses (Care Compare)

1975 4TH St
San Francisco, CA 94143-2351
Phone (415) 476-1000

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87399CAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates Pediatric Critical Care Medicine CurrentSince Jul 1, 2015 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2015 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2015 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2015 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2015 Accepting new patients
University of California San Francisco Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

1825 4th St
Fl 6
San Francisco, CA 94143
Phone (415) 353-7337

550 16th St
Ste 5571
San Francisco, CA 94158

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

300 Pasteur Dr
#5500
Stanford, CA 94305
Phone (415) 723-5525

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Interoperability endpoints

  • Direct secure messaging: mcisco72237@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1457486300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "address_2": "PACKARD CHILDRENS HOSPITAL AT STANFORD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-723-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "address_2": "PACKARD CHILDRENS HOSPITAL AT STANFORD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-723-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISCO",
        "first_name": "MICHAEL",
        "middle_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A87399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A873990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.