Individual provider Active NPI

Owen Francis Sisbarro, MD

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1609551993
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0116038074 Issued in VA
Practice address
3650 Joseph Siewick Dr Ste 400
Fairfax, VA 22033-1715
Phone
(703) 391-2020
NPI assigned
Jun 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116038074 VA Primary

Addresses

Primary practice location

3650 Joseph Siewick Dr Ste 400
Fairfax, VA 22033-1715

Mailing address

3650 Joseph Siewick Dr Ste 400
Fairfax, VA 22033-1715
Phone (703) 391-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20230817004157 DC Order and Referring Only - Family PracticePractitioner - Family Practice 3577925858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116038074VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1609551993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331715",
            "telephone_number": "703-391-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331715",
            "telephone_number": "703-391-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISBARRO",
        "first_name": "OWEN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116038074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.