Active NPI
Michael Joseph Chisam
- Radiation Oncology Physician
- Camp Lejeune, NC
National Provider Identifier
1093274342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 2020-03385
- Practice address
- 100 Brewster Blvd
Camp Lejeune, NC 28547-2575 - Phone
- (757) 953-2339
- NPI assigned
- Mar 17, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 2020-03385 | NC | Primary |
Addresses
Primary practice location
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Mailing address
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230602000659 | NC | Order and Referring Only - Radiation Oncology | 1658738844 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020-03385 | NC | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1093274342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285472575",
"telephone_number": "757-953-2339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISAM",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-17",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": "NC",
"license": "2020-03385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.