Stephen G Sisselman, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

216161 Issued in NY

Practice address

627 Broadway
Ste 1
Massapequa, NY 11758-5031

Phone

(516) 308-4040

NPI assigned

Nov 14, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sisselman Medical Group PCGroup PAC ID 4284715269, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sisselman Medical Group, PC

  • Internal Medicine Physician
  • Massapequa, NY
  • NPI 1851572358
  Medicare reassignment Care Compare group NPD Authorized official
• Atlantic Health Care Medical PC

  • Internal Medicine Physician
  • East Islip, NY
  • NPI 1720387863
  NPD (past)
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Nursing Sisters Home Care, Inc.

  • Home Health Agency
  • Farmingdale, NY
  • NPI 1780670711
  Care Compare affiliation

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1609948884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "SUITE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-308-4040",
            "fax_number": "516-804-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 BROADWAY",
            "address_2": "STE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585031",
            "telephone_number": "516-308-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSELMAN",
        "first_name": "STEPHEN",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "216161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02236377",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen.sisselman@sissmedgroup.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "627 BROADWAY",
            "address_2": "STE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117585031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kamalpreet Singh, DDS
• Tejpreet Singh, MD
• Geneva Anne Sisalima
• Sisselman Medical Group, PC
• Jill Sisselman, D.O.
• Christine Karen Sklar
• Margaret Mary Slayback, LCSW-R, CASAC
• Jacqueline Marie Slomin, RD
• Rene Small
• Casey Smith, M.S.ED, M.PHIL.ED

• Internal Medicine Physician in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.