Individual provider Active NPI

Leonardo Cisneros, DO

  • Emergency Medical Services (Emergency Medicine) Physician
  • Orlando, FL
National Provider Identifier
1770570558
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
OS0008015 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-5600
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X OS0008015 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

500 Winderley PL
Suite 115
Maitland, FL 32751-7247
Phone (407) 875-8784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110104001035 FL Practitioner - Emergency Medicine 3072702224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Nova Southeastern College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2020 Nightingale LN
Tavares, FL 32778-4361
Phone (352) 508-5254

Hospital & facility affiliations

  • Gentiva Hospice, Orlando, FL, CCN 101540

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0008015FLMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trident Wound Care LLC CurrentSince May 26, 2024 Accepting new patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medical Services CurrentSince Mar 1, 2000 Accepting new patients
Elon Health CurrentSince Apr 1, 2023 Accepting new patients
Observation Medicine Specialists LLC Past Accepting new patients

Locations

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

43378 Highway 27
Ste A5
Davenport, FL 33837

43378 Highway 27
Ste A
Davenport, FL 33837
Phone (352) 508-5254

3262 Vineland Rd
Ste 102
Kissimmee, FL 34746
Phone (407) 397-8937

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

2020 Nightingale Ln
Tavares, FL 32778
Phone (352) 508-5254

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770570558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL",
            "address_2": "SUITE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517247",
            "telephone_number": "407-875-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "LEONARDO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "OS0008015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.