Individual provider Active NPI

Diana Cisneros

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1962122895
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302546 Issued in CA
Practice address
2805 J St Ste 230
Sacramento, CA 95816-4307
Phone
(916) 497-0790
NPI assigned
Aug 31, 2022
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 302546 CA Primary

Addresses

Primary practice location

2805 J St Ste 230
Sacramento, CA 95816-4307

Mailing address

2805 J St Ste 230
Sacramento, CA 95816-4307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221017001974 CA Practitioner - Physical Therapist in Private Practice 0143696161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Select Cal Physical Therapy PCGroup PAC ID 4789070699, 162 clinicians

Practice addresses (Care Compare)

2821 J St
Sacramento, CA 95816-4315
Phone (916) 497-0790

9281 Office Park Cir
Suite 100
Elk Grove, CA 95758-8069
Phone (916) 892-1330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Cal Physical Therapy PC Physical Therapist CurrentSince Sep 3, 2022 Accepting new patients
Select Cal Physical Therapy PC CurrentSince Sep 3, 2022 Accepting new patients
Select Cal Physical Therapy PC Physical Therapist Current Accepting new patients

Locations

9281 Office Park Cir
Ste 100
Elk Grove, CA 95758
Phone (916) 892-1330

2805 J St
Sacramento, CA 95816
Phone (916) 497-0790

2805 J St
Ste 230
Sacramento, CA 95816
Phone (916) 497-0790

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1962122895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 J ST STE 230",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 J ST STE 230",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958164307",
            "telephone_number": "916-497-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.