| Mario Cisneros, | |
|
653 W 8th St # L18, Jacksonville, FL 32209-6511 | |
| (904) 244-3907 | |
| Not Available |
| Full Name | Mario Cisneros |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 11 Years |
| Location | 653 W 8th St # L18, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831584473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 70064 (Minnesota) | Primary |
| 208M00000X | Hospitalist | OS15211 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health Fargo | Fargo, ND | Hospital |
| Alomere Health | Alexandria, MN | Hospital |
| Essentia Health St Joseph's Medical Center | Brainerd, MN | Hospital |
| Essentia Health St Marys - Detroit Lakes | Detroit lakes, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Alomere Health | 9931690047 | 123 |
| Innovis Health Llc | 9931298155 | 561 |
| St Josephs Medical Center | 8224948443 | 238 |
| Entity Name | The Duluth Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902563638 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000229 |
| Entity Name | St Josephs Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568415974 PECOS PAC ID: 8224948443 Enrollment ID: O20031119000468 |
| Mailing Address | Practice Location Address |
|---|---|
| Mario Cisneros, Ssb-6, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 | Mario Cisneros, 653 W 8th St # L18, Jacksonville, FL 32209-6511 Ph: (904) 244-3907 |
Ricardo Pagan, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Dr. Bryant Mauri, DO Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 304, Jacksonville, FL 32207 Phone: 904-202-3860 |
Binh Q Doan, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1200 Riverplace Blvd, Suite 620, Jacksonville, FL 32207 Phone: 904-396-6620 Fax: 904-396-6528 |
Zelia Yanique Archibald, M.D. Hospitalist Medicare: Medicare Enrolled Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-3850 Fax: 904-244-4799 |
Dr. Vera Utagah Abaaba, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 304, Credentialing Department, Jacksonville, FL 32207 Phone: 904-202-3860 Fax: 904-202-3846 |
Dr. Naveed Ahmed, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 304, Jacksonville, FL 32207 Phone: 904-202-3860 Fax: 904-202-3846 |
Alfonso David Moreno Gutierrez, M.D Hospitalist Medicare: May Accept Medicare Assignments Practice Location: 15255 Max Leggett Pkwy, Jacksonville, FL 32218 Phone: 773-349-5197 |