Individual provider Active NPI

Josie Sisson, P.A.

  • Physician Assistant
  • Orchard Park, NY
National Provider Identifier
1811961485
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
066555 Issued in NY
Practice address
6300 Powers Rd
Orchard Park, NY 14127-3216
Phone
(716) 667-3200
Fax
(716) 667-3120
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 066555 NY Primary

Addresses

Primary practice location

6300 Powers Rd
Orchard Park, NY 14127-3216

Mailing address

6300 Powers Rd
Orchard Park, NY 14127-3216
Phone (716) 667-3200

Other identifiers 4

IdentifierTypeStateIssuer
000570271003OtherNYBC/BS
00026532802OtherNYUNIVERA
02430793MedicaidNY
9512300OtherNYIHA

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000819 NY Practitioner - Physician Assistant 0547204497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
066555NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jsissonpa@premierhealthpartners.medentdirect.com

Organizations & group practices 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1811961485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 POWERS RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273216",
            "telephone_number": "716-667-3200",
            "fax_number": "716-667-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 POWERS RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273216",
            "telephone_number": "716-667-3200",
            "fax_number": "716-667-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSON",
        "first_name": "JOSIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "066555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000570271003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026532802",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02430793",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9512300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.