CARLOS RUBEN CISNEROS (LCSW) – Clinical Social Worker, NPI 1417563362

CARLOS RUBEN CISNEROS (LCSW) is a healthcare provider. based in Las vegas, Nevada. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 10518-C (NV). The NPI Number for CARLOS RUBEN CISNEROS (LCSW) is 1417563362

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
CARLOS RUBEN CISNEROS (LCSW)
NPI
1417563362
Phone
(702) 799-9710
Address
4000 S EASTERN AVE STE 240
Enumeration Date
16 September 2020
Last Update Date
25 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7023330110
Graduation Year
2020 (6 years ago)
PAC ID
7810433349
Group Practice PAC ID
9830472372
Professional Enrollment ID
I20240930001861
Address ID
NV890306327NO2123XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

548 CLINICAL SOCIAL WORKER in NV

Provider Addresses for CARLOS RUBEN CISNEROS (LCSW)

  • 4000 S EASTERN AVE STE 240

    LAS VEGAS, NV 891190847

    Phone: (702) 799-9710

    Type: Mailing

  • 4040 N MARTIN L KING BLVD STE A

    NORTH LAS VEGAS, NV 890323205

    Phone: (702) 644-4673

    Fax: (702) 902-5443

    Type: Location

  • 8935 NEVI ROSE CT

    LAS VEGAS, NV 891485185

    Phone: (702) 793-6284

    Type: Mailing

  • 4055 SPENCER ST STE 118

    LAS VEGAS, NV 891195250

    Phone: (702) 799-9710

    Fax: (702) 799-9712

    Type: Location

  • 4000 S Eastern Ave Ste 240

    Las Vegas, NV 891190847

    Phone: (702) 848-1696

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240930001861IClinical Social WorkerNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89119)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830472372View full group profile
NameSpecialtyState
-NV
Nurse PractitionerNV

Reviews

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Frequently asked questions

What unique ID ties claims to CARLOS RUBEN CISNEROS (LCSW)?
NPI 1417563362 is assigned to CARLOS RUBEN CISNEROS (LCSW) under the national enumeration system.
Is CARLOS RUBEN CISNEROS (LCSW) currently active in the NPI registry?
CMS-published data lists CARLOS RUBEN CISNEROS (LCSW) as an active registrant.
What does CARLOS RUBEN CISNEROS (LCSW) treat or focus on?
Patients typically see CARLOS RUBEN CISNEROS (LCSW) under the specialty Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for CARLOS RUBEN CISNEROS (LCSW)?
The page summarizes Las Vegas, Nevada for CARLOS RUBEN CISNEROS (LCSW); expand the address list for detail.
Is CARLOS RUBEN CISNEROS (LCSW) a real provider?
This page reflects official NPPES data for NPI 1417563362. Always confirm identity and privileges with the practice and licensing boards.

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