Derek Jason Sisk, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11008173 Issued in FL

Practice address

3554 65TH Avenue Cir E
Sarasota, FL 34243-4116

Phone

(941) 250-4279

NPI assigned

Aug 24, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Em Alliance LLC

  • Emergency Medicine Physician
  • Wellington, FL
  • NPI 1922788959
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1003428707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3554 65TH AVENUE CIR E",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342434116",
            "telephone_number": "941-250-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3554 65TH AVENUE CIR E",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342434116",
            "telephone_number": "941-250-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISK",
        "first_name": "DEREK",
        "middle_name": "JASON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11008173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Singletary, D.O.
• Ronald D Sirianni, PA
• Nathan Sirkis, DPT
• Daniel Sirota
• Gabrielle Sirota
• Jeremy Sitkowski, LMHC
• Jamuna Sivakanthan, M.D.
• Eric Roland Sizler, MSW, LCSW
• Linda Michelle Sizler, LCSW
• SJ Hall Enterprises Inc

• Nurse Practitioner in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.