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SEAN NISAM
NPI 1003341777
Student in an Organized Health Care Education/Training Program in Vallejo, CA

Active since May 01, 2017PECOS EnrolledAccepts Medicare Assignment
975 SERENO DR, VALLEJO, CA 94589(707) 651-4071 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sean Nisam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN NISAM (NPI 1003341777) is an individual student in an organized health care education/training program in Vallejo, California and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (2017).

NPPES Registry Identity

NPI1003341777
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSEAN NISAM
Location Address975 SERENO DRVallejo, CA 94589
Mailing Address335 Carrera DrMill Valley, CA 94941-3999 · (415) 259-9013
Phone(707) 651-4071
Sole ProprietorYes
Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 2017
Enumeration DateMay 1, 2017
Last NPPES UpdateFebruary 11, 2022
✔ NPI 1003341777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
975 SERENO DR, Vallejo, CA 94589
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sean Nisam is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416360219
PECOS Enrollment IDI20210118000294
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
18 services17 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
12 services11 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERTA YIWUN WANG M.D.
Physical Medicine & Rehabilitation
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-5128
RIHONG ZHOU
Pharmacist
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-2072
EVAN HIRSCHBEIN
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 339-2074
MS. JEAN BROADNAX LCSW
Social Worker (Clinical)
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-4423
LI M. TSANG MD
Anesthesiology
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
DONN R. ERICKSON MD
Family Medicine
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
JOHN S. WOOD MD
Surgery
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
JOSE L. RECIO MD
Psychiatry & Neurology (Psychiatry)
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sean Nisam's NPI number?

The NPI number for Sean Nisam is 1003341777. It was assigned to this individual provider in the NPPES registry on May 1, 2017.

Where is Sean Nisam located?

Sean Nisam practices at 975 Sereno Dr, Vallejo, CA 94589. The listed phone number is (707) 651-4071.

What is Sean Nisam's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Sean Nisam enrolled in Medicare?

Yes. Sean Nisam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Sean Nisam was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.