Physician Compare National (NPI:1235129263)

HEALTHCARE PROVIDER: LUIS A CISNEROS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1235129263
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860528387
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100615000821
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CISNEROS
	Individual professional last name
Provider First Name	LUIS
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SAN ANTONIO INFECTIOUS DISEASES CONSULTANTS
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6800871286
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1200 BROOKLYN AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 365
	Group Practice or individual's line 2 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782124810
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2102249616
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450388
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	670055
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	METHODIST STONE OAK HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y