Active NPI
Brandon P Sis, MBA, PHARM.D
- Pharmacist
- Saint Paul, MN
National Provider Identifier
1992945273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 119875
- Practice address
- 50 Sherburne Ave
Suite 112
Saint Paul, MN 55155-1402 - Phone
- (651) 201-3106
- NPI assigned
- Feb 26, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0011746 | OR | |
| Pharmacist | 183500000X | 119875 | MN | Primary |
Addresses
Primary practice location
50 Sherburne Ave
Suite 112
Saint Paul, MN 55155-1402
Mailing address
50 Sherburne Ave
Suite 112
Saint Paul, MN 55155-1402
Phone (651) 201-3106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119875 | MN | MD | Pharmacist |
| RPH-0011746 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1992945273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 SHERBURNE AVE",
"address_2": "SUITE 112",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551551402",
"telephone_number": "651-201-3106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 SHERBURNE AVE",
"address_2": "SUITE 112",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551551402",
"telephone_number": "651-201-3106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIS",
"first_name": "BRANDON",
"middle_name": "P",
"credential": "MBA, PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-26",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0011746",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "119875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.