Gregory a. Cisneros MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME84611 Issued in FL

Legal business name

GREGORY A. CISNEROS MD PA

Practice address

33 Old Kings Rd N
Suite 2
Palm Coast, FL 32137-8227

Phone

(386) 263-2718

NPI assigned

Nov 13, 2008

Organization subpart

No

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

Authorized official

Name

Gregorio A Cisneros, M.D.NPI 1801893854

Title

Owner

Phone

(386) 263-2718

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregorio Alfonso Cisneros, MD

  • Family Medicine Physician
  • Palm Coast, FL
  • NPI 1801893854
  Medicare reassignment NPD Authorized official
• Larry Earl Reneker, D.O.

  • Family Medicine Physician
  • Flagler Beach, FL
  • NPI 1619944469
  NPD (past)

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1821242157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 OLD KINGS RD N",
            "address_2": "SUITE 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378227",
            "telephone_number": "386-263-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OLD KINGS RD N",
            "address_2": "SUITE 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378227",
            "telephone_number": "386-263-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY A. CISNEROS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "GREGORIO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-263-2718",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME84611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWNER STATE LICENSE NUMBER",
            "identifier": "ME84611",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Marie Gray, APRN
• Anngela Green
• Claudia D Green, DMD
• Christiane Greenberg
• Elizabeth Greenberger, LCSW
• Steven Gregory, PT, DPT
• Donna Marie Griffin, MFC # 42984
• Jonathan Brian Grimes, DDS
• Ariana Gross, ARNP
• Veronica Lynn Groves, PHARMD

• Family Medicine Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.