1. Home
  2. Directory
  3. Arizona
  4. San Tan Valley
  5. Pathology
  6. NPI Profile

DR. KENNETH LEE SISCO M.D.
NPI 1003937111
Pathology - Anatomic Pathology & Clinical Pathology in San Tan Valley, AZ

Active since April 03, 2007PECOS Enrolled
36386 N SECRET GARDEN PATH, SAN TAN VALLEY, AZ 85140(732) 673-7050 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 15, 2023, Jan 17, 2020 (2 updates tracked since 2020).

About Dr. Kenneth Lee Sisco M.d. NPPES

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

DR. KENNETH LEE SISCO M.D. (NPI 1003937111) is an individual anatomic pathology & clinical pathology provider in San Tan Valley, Arizona, licensed in Arizona (63928) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003937111
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameDR. KENNETH LEE SISCOCredential: M.D.
Location Address36386 N SECRET GARDEN PATHSan Tan Valley, AZ 85140-5434
Mailing Address36386 N Secret Garden PathSan Tan Valley, AZ 85140-5434 · (732) 673-7050
Phone(732) 673-7050
Sole ProprietorYes
Enumeration DateApril 3, 2007
Last NPPES UpdateJune 15, 20232 updates tracked since enumeration
NPPES CertifiedJune 15, 2023
✔ NPI 1003937111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in AZ · 63928
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
36386 N SECRET GARDEN PATH, San Tan Valley, AZ 85140
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kenneth Lee Sisco M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85140 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kenneth Sisco's NPI number?

The NPI number for Kenneth Sisco is 1003937111. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Kenneth Sisco located?

Kenneth Sisco practices at 36386 N Secret Garden Path, San Tan Valley, AZ 85140. The listed phone number is (732) 673-7050.

What is Kenneth Sisco's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Kenneth Sisco enrolled in Medicare?

Yes. Kenneth Sisco is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Sisco was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.