Individual provider Active NPI

Rosa Juanita Cisneros, M.D.

  • Obstetrics & Gynecology Physician
  • Thornton, CO
National Provider Identifier
1669451803
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
43511 Issued in CO
Practice address
9981 N Washington St
Suite 22
Thornton, CO 80229-2169
Phone
(303) 252-1247
Fax
(303) 569-6078
NPI assigned
Jan 16, 2006
Last updated
Jul 10, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 43511 CO Primary

Addresses

Primary practice location

9981 N Washington St
Suite 22
Thornton, CO 80229-2169

Mailing address

9981 N Washington St
Suite 22
Thornton, CO 80229-2169
Phone (303) 252-1247

Other identifiers 1

IdentifierTypeStateIssuer
05629021MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20060207000928 CO Practitioner - Obstetrics/Gynecology 2365457645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Colorado School of Medicine, Denver, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cisneros Center of Obstetrics and GynecologyGroup PAC ID 1557376837, 2 clinicians

Practice addresses (Care Compare)

9981 N Washington St
22 Cisneros Center of OB/GYN and Family Med
Thornton, CO 80229-2165
Phone (303) 252-1247

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43511COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Obstetrics & Gynecology Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince May 6, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince May 6, 2021 Accepting new patients
Cisneros Center of Obstetrics and Gynecology Obstetrics & Gynecology CurrentSince Dec 15, 2005 Accepting new patients
HCA Healthone LLC Past Accepting new patients

Locations

9981 Washington St
Ste 2
Thornton, CO 80229
Phone (303) 252-1247

9981 Washington St
Ste 22
Thornton, CO 80229
Phone (303) 252-1247

Organizations & group practices 5

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1669451803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9981 N WASHINGTON ST",
            "address_2": "SUITE 22",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292169",
            "telephone_number": "303-252-1247",
            "fax_number": "303-569-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 N WASHINGTON ST",
            "address_2": "SUITE 22",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292169",
            "telephone_number": "303-252-1247",
            "fax_number": "303-569-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "ROSA",
        "middle_name": "JUANITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "43511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05629021",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.