Randall L Sisam, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

LT06104A Issued in ME

Practice address

180 Kennedy Memorial Dr
Waterville, ME 04901-4540

Phone

(207) 872-5529

Fax

(207) 872-9219

NPI assigned

May 11, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Silvermount Womens Healthcare

  • Obstetrics & Gynecology Physician
  • Waterville, ME
  • NPI 1295786937
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487604435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014541",
            "telephone_number": "207-872-5529",
            "fax_number": "207-872-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014540",
            "telephone_number": "207-872-5529",
            "fax_number": "207-872-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISAM",
        "first_name": "RANDALL",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ME",
            "license": "LT06104A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodhi J. Simpson, LCPC
• Olivia Simpson, MD
• Teri J Sinclair, LPN
• Anthony Lee Sintetos, M.D., PH.D.
• Marc Sirois
• Joshua Smestad
• Charles Smith
• Gabrielle Smith
• Gail Smith, RN
• Jacob Aaron Smith

• Obstetrics & Gynecology Physician in Waterville, ME
• Providers in Waterville, ME by specialty
• Obstetrics & Gynecology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.