STEPHANIE SISAK MD
NPI 1508326059
Student in an Organized Health Care Education/Training Program in Charlotte, NC

Q: What is Stephanie Sisak's NPI number?

The NPI number for Stephanie Sisak is 1508326059. It was assigned to this individual provider in the NPPES registry on March 21, 2019.

Q: What is Stephanie Sisak's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Stephanie Sisak was last updated on May 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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 March 21, 2019PECOS Enrolled

1000 BLYTHE BLVD STE 601, CHARLOTTE, NC 28203(704) 355-7874(704) 355-5619 Get Directions Write a Review

NPPES record last updated: May 1, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 1, 2026, Mar 21, 2019 (2 updates tracked since 2019).

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About Stephanie Sisak Md NPPES

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

STEPHANIE SISAK MD (NPI 1508326059) is an individual student in an organized health care education/training program in Charlotte, North Carolina and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508326059

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameSTEPHANIE SISAKCredential: MD

Location Address1000 BLYTHE BLVD STE 601Charlotte, NC 28203-5812

Mailing Address1000 Blythe Blvd Ste 601Charlotte, NC 28203-5812 · (704) 355-7874 · Fax (704) 355-5619

Phone(704) 355-7874

Fax(704) 355-5619

Sole ProprietorNo

Enumeration DateMarch 21, 2019

Last NPPES UpdateMay 1, 20262 updates tracked since enumeration

NPPES CertifiedMay 1, 2026

✔ NPI 1508326059 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.

1000 BLYTHE BLVD STE 601, Charlotte, NC 28203

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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 (PECOS)

Stephanie Sisak Md 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.

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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.

JOSHUA SAMUEL CHAIT

Student in an Organized Health Care Education/Training Program