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CARLOS HERMENEGILDO CISNEROS JR. MD
NPI 1912793548
Student in an Organized Health Care Education/Training Program in Aurora, CO

Active since April 18, 2025PECOS Enrolled
12631 E 17TH AVE, AURORA, CO 80045(303) 724-3483 Get Directions Write a Review

NPPES record last updated: April 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carlos Hermenegildo Cisneros Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLOS HERMENEGILDO CISNEROS JR. MD (NPI 1912793548) is an individual student in an organized health care education/training program in Aurora, Colorado, licensed in Colorado (TL.0010745) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912793548
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCARLOS HERMENEGILDO CISNEROS JR.Credential: MD
Location Address12631 E 17TH AVEAurora, CO 80045-2527
Mailing Address12631 E 17th AveAurora, CO 80045-2527 · (303) 724-3483
Phone(303) 724-3483
Sole ProprietorNo
Enumeration DateApril 18, 2025
NPPES CertifiedApril 18, 2025
✔ NPI 1912793548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CO · TL.0010745
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
12631 E 17TH AVE, Aurora, CO 80045
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carlos Hermenegildo Cisneros Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNIKA DANIELLE RECZEK MD
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-5000
SARAH ASHLEY
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-1784
MARIA IZABEL KUGELMAS GUARITA LOCKWOOD
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 887-6343
ELIZABETH JONES DO
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-1784
DR. SAMANTHA NICOLE FOUNTAIN MD, MMEDSCI
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-2680
DR. BEZA TESHOME TAYACHEW MD, MPH
Internal Medicine
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-1784
HANA MUSE KUSUMOTO MPH, MD
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-1784
SPENCER SURESH BURT MD
Student in an Organized Health Care Education/Training Program
12631 E 17TH AVE
AURORA, CO 80045
Adams County (303) 724-1784

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carlos Cisneros's NPI number?

The NPI number for Carlos Cisneros is 1912793548. It was assigned to this individual provider in the NPPES registry on April 18, 2025.

Where is Carlos Cisneros located?

Carlos Cisneros practices at 12631 E 17th Ave, Aurora, CO 80045. The listed phone number is (303) 724-3483.

What is Carlos Cisneros's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Carlos Cisneros enrolled in Medicare?

Yes. Carlos Cisneros is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carlos Cisneros was last updated on April 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.