Individual provider Active NPI

Sisay Akalu, M.D.

  • Occupational Medicine Physician
  • Corning, NY
National Provider Identifier
1457776395
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
296054 Issued in NY
Practice address
130 Center Way
Corning, NY 14830
Phone
(607) 936-9971
Fax
(607) 962-8938
NPI assigned
Mar 1, 2014
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X C1-0008356 DE
Occupational Medicine Physician 2083X0100X C1-0008356 DE
Occupational Medicine Physician 2083X0100X 296054 NY Primary

Addresses

Primary practice location

130 Center Way
Corning, NY 14830

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other practice location 1

263 Farmington Avenue
CMHC/UConn Health
Farmington, CT 06030
Phone (860) 679-5500

Other practice location 2

263 Farmington Avenue
CMHC/UConn Health
Farmington, CT 06030
Phone (860) 679-5500

Other practice location 3

263 Farmington Avenue
CMHC/UConn Health
Farmington, CT 06030
Phone (860) 679-5500

Other practice location 4

263 Farmington Avenue
CMHC/UConn Health
Farmington, CT 06030
Phone (860) 679-5500

Other names 1

  • Sisay T Akalu Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sakalu140957@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181228001476 NY Practitioner - Preventive Medicine 5193019370 Reassigns benefits to 1 organization
I20181231000119 PA Practitioner - Preventive Medicine 5193019370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296054NYMDLicensed Practical Nurse
C1-0008356DEMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Dec 11, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Dec 11, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Dec 11, 2018 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: sakalu140957@direct-guthrie.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1393632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1457776395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CENTER WAY",
            "city": "CORNING",
            "state": "NY",
            "postal_code": "14830",
            "telephone_number": "607-936-9971",
            "fax_number": "607-962-8938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Avenue",
            "address_2": "CMHC/UConn Health",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-5500",
            "fax_number": "860-679-5552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Avenue",
            "address_2": "CMHC/UConn Health",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-5500",
            "fax_number": "860-679-5552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Avenue",
            "address_2": "CMHC/UConn Health",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-5500",
            "fax_number": "860-679-5552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Avenue",
            "address_2": "CMHC/UConn Health",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-5500",
            "fax_number": "860-679-5552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKALU",
        "first_name": "SISAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-01",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "DE",
            "license": "C1-0008356",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "DE",
            "license": "C1-0008356",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NY",
            "license": "296054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sakalu140957@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "130 Center Way",
            "city": "Corning",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SISAY",
            "last_name": "AKALU",
            "middle_name": "T",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Corning, NY

Sources for this page

Verify at the official NPI Registry.