DEREK SISAK DC - NPI 1699272153 - Chiropractor in Charlottesville, VA

Q: What is Derek Sisak's NPI number?

The NPI number for Derek Sisak is 1699272153. It was assigned to this individual provider in the NPPES registry on April 11, 2018.

Q: What is Derek Sisak's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Sisak was last updated on April 11, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Derek Sisak Dc NPPES

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

DEREK SISAK DC (NPI 1699272153) is an individual chiropractor in Charlottesville, Virginia, licensed in Virginia (0104557344) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1699272153

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameDEREK SISAKCredential: DC

Location Address2109 INDIA RDCharlottesville, VA 22901-2886

Mailing Address2109 India RdCharlottesville, VA 22901-2886 · (434) 978-4888 · Fax (434) 978-3633

Phone(434) 978-4888

Fax(434) 978-3633

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 11, 2018

✔ NPI 1699272153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in VA · 0104557344

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

2109 INDIA RD, Charlottesville, VA 22901

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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)

Derek Sisak Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729481429

PECOS Enrollment IDI20210719001801

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.

Other Providers at the Same Location NPPES 7

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

DR. JASON HARPER DC

Chiropractor