Active NPI
Carlos Joaquin Cisneros, PHARM D.
- Pharmacist
- Pueblo West, CO
National Provider Identifier
1659128536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19562
- Practice address
- 1017 N Market PLZ
Pueblo West, CO 81007-1502 - Phone
- (719) 547-2913
- NPI assigned
- Apr 30, 2024
- Last updated
- Apr 30, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19562 | CO | Primary |
Addresses
Primary practice location
1017 N Market PLZ
Pueblo West, CO 81007-1502
Mailing address
103 Argyle Ave
Pueblo, CO 81004-1007
Phone (719) 214-7637
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19562 | CO | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1659128536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 ARGYLE AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810041007",
"telephone_number": "719-214-7637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 N MARKET PLZ",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810071502",
"telephone_number": "719-547-2913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CISNEROS",
"first_name": "CARLOS",
"middle_name": "JOAQUIN",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-30",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "19562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo West, CO
- Katherine Chadderdon
- Stephanie Amanda Chamberlin
- Cherish Life Mentorship Program
- Choice by Choice Counseling & Consulting LLC
- Tara Marie Sidiq Christensen, CSFA
- Reece Cochran, DDS
- Colorado Compass Network
- Colorado Compass Network
- Colorado Dental Professionals, LLC (Sangre de Cristo Dental Care)
- Karen W. Colvin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.