Individual provider Active NPI

Sisom Osia, M.D

  • Internal Medicine Physician
  • Upper Marlboro, MD
National Provider Identifier
1154442366
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0048158 Issued in MD
Practice address
9628 Marlboro Pike
Upper Marlboro, MD 20772
Phone
(301) 599-7010
Fax
(301) 599-1222
NPI assigned
Apr 3, 2007
Last updated
Mar 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0048158 MD Primary

Addresses

Primary practice location

9628 Marlboro Pike
Upper Marlboro, MD 20772

Mailing address

PO Box 2070
Upper Marlboro, MD 20773-2070
Phone (301) 599-7010

Other identifiers 1

IdentifierTypeStateIssuer
051701101MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20051115000152 DC Practitioner - Internal MedicinePractitioner - Emergency Medicine 9335168889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9628 Marlboro Pike
Upper Marlboro, MD 20772-3767
Phone (301) 599-7010

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sisom.osia@24925.chartlogic.direct-ci.com
  • Direct secure messaging: sosia@gmc-md.direct.office.nextgen.com

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1154442366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207732070",
            "telephone_number": "301-599-7010",
            "fax_number": "301-599-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9628 MARLBORO PIKE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "301-599-7010",
            "fax_number": "301-599-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSIA",
        "first_name": "SISOM",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0048158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051701101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.