Individual provider Active NPI

Bockarie Sesay, PA

  • Physician Assistant
  • Stockbridge, GA
National Provider Identifier
1366611808
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004514 Issued in GA
Practice address
108 Lumby LN
Stockbridge, GA 30281-0908
Phone
(678) 565-1892
Fax
(678) 565-1892
NPI assigned
Feb 28, 2008
Last updated
Feb 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004514 GA Primary

Addresses

Primary practice location

108 Lumby LN
Stockbridge, GA 30281-0908

Mailing address

108 Lumby LN
Stockbridge, GA 30281-0908
Phone (678) 565-1892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004514GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1366611808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 LUMBY LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302810908",
            "telephone_number": "678-565-1892",
            "fax_number": "678-565-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LUMBY LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302810908",
            "telephone_number": "678-565-1892",
            "fax_number": "678-565-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESAY",
        "first_name": "BOCKARIE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.