Individual provider Active NPI

James Paul Sisk II, D.O.

  • Hospitalist Physician
  • Joplin, MO
National Provider Identifier
1790726222
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2012017692 Issued in MO
Practice address
1102 W 32ND St
Joplin, MO 64804-3503
Phone
(417) 347-4570
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3787 OK
Hospitalist Physician 208M00000X 3787 OK
Internal Medicine Physician 207R00000X 2012017692 MO
Hospitalist Physician 208M00000X 2012017692 MO Primary

Addresses

Primary practice location

1102 W 32ND St
Joplin, MO 64804-3503

Mailing address

PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-4570

Other identifiers 1

IdentifierTypeStateIssuer
100102650AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120810000790 MO Practitioner - HospitalistPractitioner - Internal Medicine 7214848357 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012017692MOMDHospitalist Physician
3787OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Newkirk Rural Health Clinic Past Accepting new patients
Internal Medicine Associates of Ponca City PLLC PastSince Jun 1, 2019 Accepting new patients

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1790726222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3810",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648033810",
            "telephone_number": "417-347-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043503",
            "telephone_number": "417-347-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISK",
        "first_name": "JAMES",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "3787",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "3787",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012017692",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2012017692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100102650A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.