NPIMap

Individual provider Active NPI

Mario Cisneros

  • Hospitalist Physician
  • Jacksonville, FL
National Provider Identifier
1831584473
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
70064 Issued in MN
Practice address
653 W 8TH St # L18
Jacksonville, FL 32209-6511
Phone
(904) 244-3907
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 70064 MN Primary
Hospitalist Physician 208M00000X OS15211 FL

Addresses

Primary practice location

653 W 8TH St # L18
Jacksonville, FL 32209-6511

Mailing address

SSB-6
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, MN, ND3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190912000542 ME Practitioner - Hospitalist 3577878644 Reassigns benefits to 1 organization
I20211007000494 MN Practitioner - Hospitalist 3577878644 Reassigns benefits to 2 organizations
I20260226000828 ND Practitioner - Hospitalist 3577878644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere Health 123 clinicians
Innovis Health LLC 561 clinicians
St Josephs Medical Center 238 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7400

Hospital & facility affiliations

  • Essentia Health Hospital, Fargo, ND, CCN 350070
  • Alomere Health Hospital, Alexandria, MN, CCN 240030
  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075
  • Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15211FLMDHospitalist Physician
70064MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Oct 4, 2021 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Eastern Maine Medical Center CurrentSince Aug 11, 2019 Accepting new patients
St. Joseph'S Medical Center CurrentSince Jul 24, 2023 Accepting new patients
Innovis Health, LLC. CurrentSince Jan 13, 2026 Accepting new patients
Alexandria Clinic PA Current Accepting new patients
St Joseph'S Medical Center CurrentSince Jul 24, 2023 Accepting new patients
Eastern Maine Medical Center CurrentSince Aug 11, 2019 Accepting new patients
The Duluth Clinic LTD CurrentSince Oct 4, 2021 Accepting new patients
Innovis Health LLC CurrentSince Jan 13, 2026 Accepting new patients
Douglas County Hospital Current Accepting new patients
Innovis Health, LLC Past Accepting new patients

Locations

489 State St
Ste A
Bangor, ME 04401

489 State St
Bangor, ME 04401
Phone (207) 973-8837

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

610 30th Ave W
Alexandria, MN 56308
Phone (320) 763-2540

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Interoperability endpoints

  • Direct secure messaging: mcisneros790336@direct.hopkinsmedicine.org

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1831584473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SSB-6",
            "address_2": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST # L18",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "MARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "70064",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS15211",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.