Jill Sisselman, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

216154 Issued in NY

Practice address

627 Broadway
Suite 1
Massapequa, NY 11758-5031

Phone

(516) 308-4040

Fax

(516) 804-6386

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sisselman Medical Group PCGroup PAC ID 4284715269, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jill.sisselman@sissmedgroup.eclinicaldirectplus.com

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.

• Sisselman Medical Group, PC

  • Internal Medicine Physician
  • Massapequa, NY
  • NPI 1851572358

  Family Medicine

  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD (past)
• Rakesh Sharma Physician PC

  • Internal Medicine Physician
  • Lake Ronkonkoma, NY
  • NPI 1831462464
  NPD (past)

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

• Nursing Sisters Home Care, Inc.

  • Home Health Agency
  • Farmingdale, NY
  • NPI 1780670711
  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1295895480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "SUITE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-308-4040",
            "fax_number": "516-804-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "SUITE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-308-4040",
            "fax_number": "516-804-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSELMAN",
        "first_name": "JILL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "216154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02236368",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jill.sisselman@sissmedgroup.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "address_1": "627 Broadway",
            "address_2": "Suite 1",
            "city": "Massapequa",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117585031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sahida Singh-Rhoden, BCBA, LBA
• Kamalpreet Singh, DDS
• Tejpreet Singh, MD
• Geneva Anne Sisalima
• Sisselman Medical Group, PC
• Stephen G Sisselman, DO
• Christine Karen Sklar
• Margaret Mary Slayback, LCSW-R, CASAC
• Jacqueline Marie Slomin, RD
• Rene Small

• Family Medicine Physician in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.