Individual provider Active NPI

Alisa Siebrasse

  • Internal Medicine Physician
  • Chapel Hill, NC
National Provider Identifier
1689294084
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2023-00405 Issued in NC
Practice address
102 Mason Farm Rd
Chapel Hill, NC 27514-4617
Phone
(984) 974-4462
Fax
(919) 843-9355
NPI assigned
Apr 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 261474 NC
Internal Medicine Physician 207R00000X 2023-00405 NC Primary

Addresses

Primary practice location

102 Mason Farm Rd
Chapel Hill, NC 27514-4617

Mailing address

102 Mason Farm Rd
Chapel Hill, NC 27514-4617
Phone (984) 974-4462

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asiebrasse563935@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230718003417 NC Practitioner - Internal Medicine 4082045463 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023-00405NCMDInternal Medicine Physician
261474NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill Internal Medicine CurrentSince Jun 28, 2023 Accepting new patients

Locations

102 Mason Farm Rd
Chapel Hill, NC 27514
Phone (919) 966-1459

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Interoperability endpoints

  • Direct secure messaging: asiebrasse563935@direct.unc.nchie.net
  • Direct secure messaging: asiebrasse312084@directhisp.wakemed.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1587859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1689294084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144617",
            "telephone_number": "984-974-4462",
            "fax_number": "919-843-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144617",
            "telephone_number": "984-974-4462",
            "fax_number": "919-843-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBRASSE",
        "first_name": "ALISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-26",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "261474",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2023-00405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asiebrasse563935@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.