BIANCA JADE BRISENO (AGACNP-BC) – Acute Care Nurse Practitioner, NPI 1124980024
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,440 NURSE PRACTITIONER in TX
Provider Addresses for BIANCA JADE BRISENO (AGACNP-BC)
4502 MEDICAL DR
SAN ANTONIO, TX 782294402
Phone: (210) 358-4000
Fax: (210) 358-4775
Type: Mailing
4502 Medical Dr
San Antonio, TX 782294402
Phone: (210) 358-4000
Fax: (210) 358-4775
Type: Location
204 WINSLOW RUN
CIBOLO, TX 781084567
Phone: (432) 559-5412
Type: Mailing
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: 2025-12-11
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251211003992 | I | Nurse Practitioner | TX | TBD |
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.
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 78229)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Nurse Practitioner | TX | |
| Family Practice | TX | |
| Hospitalist, Internal Medicine | TX | |
| - | TX | |
| - | TX | |
| Interventional Cardiology, Internal Medicine, Cardiovascular Disease (Cardiology) | TX | |
| A N E S T H E S I O L O G Y | TX | |
| Family Practice | TX | |
| Nurse Practitioner | TX |
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