Derek Sisak, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104557344 Issued in VA

Practice address

2109 India Rd
Charlottesville, VA 22901-2886

Phone

(434) 978-4888

Fax

(434) 978-3633

NPI assigned

Apr 11, 2018

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

Enrolled in FL

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

ChiropracticAlso: Physical Medicine and Rehabilitation, Preventive Medicine

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Spinal Solutions Health and WellnessGroup PAC ID 3678976362, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Spinal Solutions Health and Wellness

  • Chiropractor
  • St Augustine, FL
  • NPI 1083297915
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1699272153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 INDIA RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229012886",
            "telephone_number": "434-978-4888",
            "fax_number": "434-978-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 INDIA RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229012886",
            "telephone_number": "434-978-4888",
            "fax_number": "434-978-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISAK",
        "first_name": "DEREK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia La Bella Sink, LPC
• Robert Alan Sinkin, M.D.
• Helmy M. Siragy, M.D.
• Imrana Siraj, MD
• Michelle Ly NN Sirch, PH.D., L.P.C., N.C.C
• Sisu Systems
• Anita Sites, ACNP
• Siva Thiagarajah, MD
• William Paul Skelton IV, M.D.
• Maria Skladanowski, RDN

• Chiropractor in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.