Individual provider Active NPI

Chloe Eve Sisneros, PA

  • Physician Assistant
  • Cadillac, MI
National Provider Identifier
1629766498
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012564 Issued in MI
Practice address
400 Hobart St
Cadillac, MI 49601-2331
Phone
(231) 876-7200
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601012564 MI Primary

Addresses

Primary practice location

400 Hobart St
Cadillac, MI 49601-2331

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240831000039 MI Practitioner - Physician Assistant 3375082522 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012564MIMDPhysician Assistant

Organizations & group practices 1

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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1629766498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOBART ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012331",
            "telephone_number": "231-876-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISNEROS",
        "first_name": "CHLOE",
        "middle_name": "EVE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.