Paige E Cisna, NP
Individual provider Active NPI Family Nurse Practitioner · South Bend, IN
NPI 1578090650 · NPPES record last updated May 19, 2017
Key facts
- NPI
- 1578090650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 28210007A (IN)
- Practice address
- 211 N Eddy St
South Bend, IN 46617-2808 - Phone
- (574) 204-6739
- NPI assigned
- May 19, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The South Bend Clinic LLC
Practice addresses (Care Compare)
211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161
Hospital & facility affiliations
- Memorial Hospital of South Bend
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170825000661 | IN | Practitioner - Nurse Practitioner | 1557633500 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28210007A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The South Bend Clinic, LLC | Current |
Accepting new patients | |
| The South Bend Clinic LLC | Current |
Accepting new patients | |
| Brookside Medical Home Visits LLC | Current |
Accepting new patients | |
| Brookside Medical Home Visits LLC | Family | Current |
Accepting new patients |
Locations
211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331
Interoperability endpoints
- pcisna252987@dulyhealthandcare.direct-ci.com
- https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/
- paige.cisna.1@28056.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28210007A | IN | Yes |
Addresses
Primary practice location
211 N Eddy St
South Bend, IN 46617-2808
Mailing address
211 N Eddy St
South Bend, IN 46617-2808
Other names
- Paige Stroinski
Other providers in South Bend, IN
- Brenda L Chupp
- Adam Joseph Cien
- Wendi Ciesielska
- Mori Ciesiolka
- Fatema Lynn Cischke
- City of South Bend
- Deborah Kay Clardy
- Jayla Clark
- Kara Clark
- Ron Clark
All providers in South Bend, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.