Active NPI
Anil Sishta
- Dentist
- Levittown, NY
National Provider Identifier
1063978112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 061208
- Practice address
- 21 Division Ave
Levittown, NY 11756-2919 - Phone
- (516) 274-0101
- NPI assigned
- Feb 13, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 061208 | NY | Primary |
Addresses
Primary practice location
21 Division Ave
Levittown, NY 11756-2919
Mailing address
1 3Rd Ave Apt 908
Mineola, NY 11501-4349
Phone (908) 328-5263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190730002241 | NY | Order and Referring Only - Dentist | 7315273257 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 061208 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1063978112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 3RD AVE APT 908",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115014349",
"telephone_number": "908-328-5263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 DIVISION AVE",
"city": "LEVITTOWN",
"state": "NY",
"postal_code": "117562919",
"telephone_number": "516-274-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISHTA",
"first_name": "ANIL",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-13",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "061208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Levittown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.