Individual provider Active NPI

Nisha Cyriac

  • Family Nurse Practitioner
  • Joliet, IL
National Provider Identifier
1689238420
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.018883 Issued in IL
Practice address
1051 Essington Rd Ste 250
Joliet, IL 60435-2803
Phone
(815) 300-7764
NPI assigned
Apr 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.018883 IL Primary

Addresses

Primary practice location

1051 Essington Rd Ste 250
Joliet, IL 60435-2803

Mailing address

1051 Essington Rd Ste 250
Joliet, IL 60435-2803
Phone (815) 300-7764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20191016001424 IL Practitioner - Nurse Practitioner 7810228285 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.018883ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1689238420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD STE 250",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352803",
            "telephone_number": "815-300-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD STE 250",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352803",
            "telephone_number": "815-300-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "NISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.018883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.