Individual provider Active NPI

Patricia Louise Cisneros, AGNP

  • Adult Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1578051314
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP137064 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229
Phone
(210) 450-9000
Fax
(210) 450-4903
NPI assigned
Apr 26, 2018
Last updated
Dec 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP137064 TX Primary
Registered Nurse 163W00000X 938960 TX
Registered Nurse 163W00000X RN9192219 FL

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 450-9000

Other practice location 1

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 819-4610

Other practice location 2

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 819-4610

Other identifiers 2

IdentifierTypeStateIssuer
390404702OtherTXCSHCN
390404701MedicaidTX

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
I20181024002505 TX Practitioner - Nurse Practitioner 8325391121 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Texas, PLLCGroup PAC ID 7618237264, 398 clinicians
South Texas Physician Services, PLLCGroup PAC ID 5890145783, 57 clinicians

Practice addresses (Care Compare)

1401 Medical Pkwy
Cedar Park, TX 78613-7763
Phone (512) 528-7000

600 N Union Ave
New Braunfels, TX 78130-4194
Phone (830) 606-9111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9192219FLMDRegistered Nurse
938960TXMDRegistered Nurse
AP137064TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Nov 1, 2018 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Nov 1, 2018 Accepting new patients
South Texas Physician Services, PLLC CurrentSince Sep 1, 2025 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Sep 18, 2025 Accepting new patients
VHS San Antonio Partners LLC Past Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

600 N Union Ave
New Braunfels, TX 78130
Phone (830) 606-9111

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1578051314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-450-9000",
            "fax_number": "210-450-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-450-9000",
            "fax_number": "210-450-4903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "904-819-4610",
            "fax_number": "904-819-4994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "904-819-4610",
            "fax_number": "904-819-4994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "PATRICIA",
        "middle_name": "LOUISE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP137064",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "938960",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9192219",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "390404702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390404701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.