Mary S Kisswany, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2024-00315 Issued in NC

Practice address

1600 E C St
Butner, NC 27509-2530

Phone

(919) 575-1890

Fax

(919) 575-1637

NPI assigned

Jul 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Capital Health Multispecialty Group

  • Surgery Physician
  • Trenton, NJ
  • NPI 1083072342

  Internal Medicine

  Medicare reassignment NPD
• Hospitalist Physicians of New Jersey PA

  • Hospitalist Physician
  • Edison, NJ
  • NPI 1588021851

  Internal Medicine

  Medicare reassignment NPD
• Inhospital Physicians Corp of New Jersey, PC

  • Internal Medicine Physician
  • Rochelle Park, NJ
  • NPI 1336625425
  Medicare reassignment NPD
• Murdoch Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • Butner, NC
  • NPI 1699811125
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1356506166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E C ST",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275092530",
            "telephone_number": "919-575-1890",
            "fax_number": "919-575-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E C ST",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275092530",
            "telephone_number": "919-575-1890",
            "fax_number": "919-575-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSWANY",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "LA",
            "license": "000246",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2024-00315",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MB08436700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172146",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE-TEANECK",
            "identifier": "P00829442",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00667653",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP-PHYS ASSOC OF TEANECK",
            "identifier": "48090-NON PAR",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlyle Robinson Kennedy, LCSW-A
• Cynthia Parker Kidd, MSW, LCSW
• Matthew M King, MD
• Lydia Danette Kinton
• Melissa Nicole Donnelly Kirkton, PHARMD
• Gary Michael Klein, M.D.
• Margaret Elizabeth Kneifel, MD
• Shiela Jane Koehn, COTA/L
• Aimee Meredith Kresica, LCSW
• Wilby Kurian

• Internal Medicine Physician in Butner, NC
• Providers in Butner, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.