SALY SISOUVONG M.D.
NPI 1407040991
Internal Medicine in Oakland, CA

Q: What is Saly Sisouvong's NPI number?

The NPI number for Saly Sisouvong is 1407040991. It was assigned to this individual provider in the NPPES registry on August 28, 2007.

Q: What is Saly Sisouvong's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Saly Sisouvong 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.

Active since August 28, 2007PECOS EnrolledAccepts Medicare Assignment

280 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-1000 Get Directions Write a Review

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

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About Saly Sisouvong M.d. NPPES

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

SALY SISOUVONG M.D. (NPI 1407040991) is an individual internal medicine provider in Oakland, California, licensed in California (A 99507) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Hawaii John A. Burns School Of Medicine (2004).

NPPES Registry Identity

NPI1407040991

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSALY SISOUVONGCredential: M.D.

Location Address280 W MACARTHUR BLVDOakland, CA 94611-5642

Mailing Address495 Townsend DrBenicia, CA 94510-3952 · (707) 319-9460

Phone(510) 752-1000

Sole ProprietorYes

Medical School CMSUniversity Of Hawaii John A. Burns School Of MedicineGraduated 2004

Enumeration DateAugust 28, 2007

Last NPPES UpdateFebruary 11, 2022

✔ NPI 1407040991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A 99507

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

280 W MACARTHUR BLVD, Oakland, CA 94611

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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

Saly Sisouvong M.d. 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 ID1759444128

PECOS Enrollment IDI20090112000173

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

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.

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94611 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

$153.83 typical visit price

range $69.00 – $202.35

Typical copayment $38.45 (range $17.25 – $50.58)

Most-billed visit code 99204

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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.

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.

JESSICA CHANG PHARM.D., APH

Pharmacist