Paola A Palma Sisto, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

42192 Issued in WI

Practice address

2575 E Evergreen Drive
Appleton, WI 54913-8904

Phone

(920) 969-5353

Fax

(414) 337-7201

NPI assigned

May 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppalmasisto13417@direct.chw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1982658936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 E EVERGREEN DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138904",
            "telephone_number": "920-969-5353",
            "fax_number": "414-337-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 E EVERGREEN DRIVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138904",
            "telephone_number": "920-969-5353",
            "fax_number": "414-337-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Redbird Cir",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541157977",
            "country_code": "US",
            "telephone_number": "920-969-5353",
            "fax_number": "414-337-7201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264874",
            "country_code": "US",
            "telephone_number": "414-266-2860",
            "fax_number": "414-266-6749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMA SISTO",
        "first_name": "PAOLA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "WI",
            "license": "42192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002006261K",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982658936",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pain Centers of Wisconsin - Appleton, LLC
• Pain Relief 1 LLC
• Amy Marie Paine, COTA
• Jolanta M Pajek, D.D.S.
• Kristen Pallex, ATC, LAT
• Jillian Lee Palmbach, 17632-130
• Alex James Palubicki
• Luke Pan, PT, DPT
• Amy Pankow, PHARMD., RPH
• Bethany Pankratz, MA

• Pediatric Endocrinology Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Pediatric Endocrinology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.