Individual provider Active NPI

David A Sisam, DO

  • Endocrinology, Diabetes & Metabolism Physician
  • Houma, LA
National Provider Identifier
1124194840
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
06691R Issued in LA
Practice address
855 Belanger St
Suite 100
Houma, LA 70360
Phone
(985) 876-5451
Fax
(985) 876-2025
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 06691R LA Primary

Addresses

Primary practice location

855 Belanger St
Suite 100
Houma, LA 70360

Mailing address

855 Belanger St
Suite 100
Houma, LA 70360
Phone (985) 876-5451

Other identifiers 1

IdentifierTypeStateIssuer
1349054MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070604000219 LA Practitioner - Endocrinology 1153429824 Practice locations: Houma, LA

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
College of Osteopathic Physicians and Surgeons of Los Angeles, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

855 Belanger St
Houma, LA 70360-4463
Phone (985) 873-5451

Hospital & facility affiliations

  • Terrebonne General Medical Center - Parish Hospital, Houma, LA, CCN 190008
  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004
  • Ochsner St Mary Hospital, Morgan City, LA, CCN 190014
  • Ochsner St Anne General Hospital Hospital, Raceland, LA, CCN 191324
  • Lady of the Sea General Hospital Hospital, Cut Off, LA, CCN 191325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
06691RLAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Center of the South PastSince Jun 4, 2007 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124194840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 BELANGER ST",
            "address_2": "SUITE 100",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-876-5451",
            "fax_number": "985-876-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 BELANGER ST",
            "address_2": "SUITE 100",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-876-5451",
            "fax_number": "985-876-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISAM",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "LA",
            "license": "06691R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1349054",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.