Individual provider Active NPI

Sierra Marie Sisson, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1487133369
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C007644 Issued in MD
Practice address
345 Saint Paul St
Baltimore, MD 21202-2123
Phone
(410) 332-9000
NPI assigned
Aug 10, 2018
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 022447 NY
Medical Physician Assistant 363AM0700X C007644 MD Primary

Addresses

Primary practice location

345 Saint Paul St
Baltimore, MD 21202-2123

Mailing address

10945 Price Manor Way Apt 441
Laurel, MD 20723-6054
Phone (585) 208-2182

Other practice location 1

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C007644MDMDMedical Physician Assistant
022447NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1487133369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 PRICE MANOR WAY APT 441",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207236054",
            "telephone_number": "585-208-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Long Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264122",
            "country_code": "US",
            "telephone_number": "585-723-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISSON",
        "first_name": "SIERRA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "022447",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C007644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.