Active NPI
Gerardo P. Sison, Jr., M.D., P.a.
- Psychiatry Physician
- Palm Harbor, FL
National Provider Identifier
1962678110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME53725
- Legal business name
- GERARDO P. SISON, JR., M.D., P.A.
- Practice address
- 34650 US Highway 19 N
Suite 107
Palm Harbor, FL 34684-2155 - Phone
- (727) 787-3422
- Fax
- (727) 787-5624
- NPI assigned
- May 7, 2008
- Organization subpart
- Yes
- Parent organization
- GERARDO P. SISON, JR., M.D.. P.A.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Virginia Dee Sison
- Title
- Office Manager
- Phone
- (727) 787-3422
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME53725 | FL | Primary |
Addresses
Primary practice location
34650 US Highway 19 N
Suite 107
Palm Harbor, FL 34684-2155
Mailing address
34650 US Highway 19 N
Suite 107
Palm Harbor, FL 34684-2155
Phone (727) 787-3422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 064334300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Gerardo P Sison Jr MD
Locations
34650 US Highway 19 N
Ste 107
Palm Harbor, FL 34684
Phone (727) 787-3422
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Palm Harbor, FL
- NPI 1275553174
-
- Psychiatric/Mental Health Nurse Practitioner
- Brooksville, FL
- NPI 1639390263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332806400000",
"number": "1962678110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34650 US HIGHWAY 19 N",
"address_2": "SUITE 107",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346842155",
"telephone_number": "727-787-3422",
"fax_number": "727-787-5624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34650 US HIGHWAY 19 N",
"address_2": "SUITE 107",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346842155",
"telephone_number": "727-787-3422",
"fax_number": "727-787-5624"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GERARDO P. SISON, JR., M.D., P.A.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GERARDO P. SISON, JR., M.D.. P.A.",
"enumeration_date": "2008-05-07",
"last_updated": "2012-03-27",
"status": "A",
"authorized_official_last_name": "SISON",
"authorized_official_first_name": "VIRGINIA",
"authorized_official_middle_name": "DEE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "727-787-3422",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME53725",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "064334300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.