Djaris Cisneros

Individual provider Active NPI Prosthetic/Orthotic Supplier · Independence, MO

NPI 1932051133 · NPPES record last updated Feb 10, 2026

Key facts

NPI
1932051133
Entity type
Individual (NPI type 1)
Primary specialty
Prosthetic/Orthotic Supplier 335E00000X
License
1999134831 (MO)
Practice address
2400 S Lees Summit Rd
Independence, MO 64055-1937
Phone
(816) 986-0444
NPI assigned
Feb 10, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1999134831MOMDProsthetic/Orthotic Supplier

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 1999134831 MO Yes

Addresses

Primary practice location

2400 S Lees Summit Rd
Independence, MO 64055-1937

Mailing address

2400 S Lees Summit Rd
Independence, MO 64055-1937
Phone (816) 986-0444

Other providers in Independence, MO

All providers in Independence, MO · Prosthetic/Orthotic Supplier in Missouri

Sources for this page

Verify at the official NPI Registry.