Medard Tolentino Sison, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95008535 Issued in CA

Practice address

4441 E Kings Canyon Rd
Fresno, CA 93702-3604

Phone

(559) 840-7628

NPI assigned

Feb 3, 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 CA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health and Nursing PCGroup PAC ID 5294151635, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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.

• Mental Health and Nursing PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaheim, CA
  • NPI 1528693579
  Medicare reassignment Care Compare group Authorized official
• Renewed Medical Group, a Professional Medical Corporation

  • Psychiatry Physician
  • Anaheim, CA
  • NPI 1922785690

  Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Coast Medical, PC

  • Psychiatry Physician
  • Anaheim, CA
  • NPI 1780435628

  Psychiatric/Mental Health

  Medicare reassignment NPD
• County of Fresno

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresno, CA
  • NPI 1770538001
  Medicare reassignment NPD
• Eag Professional Medical Corp.

  • Psychiatry Physician
  • Ceres, CA
  • NPI 1841483427
  Medicare reassignment NPD
• Mellow Medical Inc a Professional Corporation

  • Psychiatry Physician
  • West Hollywood, CA
  • NPI 1407275886
  Medicare reassignment NPD
• RCMH, Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Cypress, CA
  • NPI 1043187776
  Medicare reassignment NPD
• County of Fresno

  • State or Local Public Health Clinic/Center
  • Fresno, CA
  • NPI 1174606420
  NPD
• Renewed Community Mental Health

  • Psychiatry Physician
  • Anaheim, CA
  • NPI 1912736026

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1517616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1922507037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4276 KATELLA AVE STE 220",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-840-7628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Hughes Way Ste 150",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908101878",
            "country_code": "US",
            "telephone_number": "310-221-6336 x128",
            "fax_number": "310-221-6350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISON",
        "first_name": "MEDARD",
        "middle_name": "TOLENTINO",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-03",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95008535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manisha Sisodia, D.D.S.
• Angelica Faith Sison, AMFT
• Desiree Sison, O.D.
• Lucas M Sison
• Mark Algara Sison, M.D.
• Destiny Sakura Sisowath
• Kevin Sit
• Ana Sitolini, OTR/L
• Kaitlyn Michelle Sitts, NP
• Carol Sitze

• Psychiatric/Mental Health Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.