SISSELMAN MEDICAL GROUP, PC
NPI 1851572358
Internal Medicine in Massapequa, NY

Active since November 26, 2007CLIA 33D1079653 · Waiver
627 BROADWAY, SUITE 1, MASSAPEQUA, NY 11758(516) 308-4040(516) 804-6386 Get Directions Write a Review

NPPES record last updated: October 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sisselman Medical Group, Pc NPPES

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

SISSELMAN MEDICAL GROUP, PC (NPI 1851572358) is a healthcare organization registered as an internal medicine in Massapequa, New York and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Stephen Sisselman, President, as its authorized official.

NPPES Registry Identity

NPI1851572358
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSISSELMAN MEDICAL GROUP, PC
Location Address627 BROADWAY, SUITE 1Massapequa, NY 11758-5031
Mailing Address627 Broadway, Suite 1Massapequa, NY 11758-5031 · (516) 308-4040 · Fax (516) 804-6386
Fax(516) 804-6386
Organization SubpartNo
Authorized OfficialStephen SisselmanPresident · (516) 308-4040
Enumeration DateNovember 26, 2007
Last NPPES UpdateOctober 12, 2022
NPPES CertifiedOctober 12, 2022
NPI 1851572358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in NY · 216161
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.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 216154 (NY)
627 BROADWAY, Massapequa, NY 11758

Other Identifiers 1

Medicaid05215494NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1079653

Sisselman Medical Group - Massapequa · Massapequa, NY
Active · expires Mar 26, 2027
CLIA Number33D1079653
Laboratory TypePhysician Office
Certificate Effective DateNovember 23, 2015
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Stephen G. Sisselman
Laboratory Phone(516) 308-4040
Laboratory LocationSisselman Medical Group - Massapequa627 Broadway - Suite 1, Massapequa, NY 11758
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

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

Social Worker (Clinical)
627 BROADWAY, SUITE 205
MASSAPEQUA, NY 11758
Physician Assistant
627 BROADWAY, SUITE 1
MASSAPEQUA, NY 11758
Social Worker
627 BROADWAY
MASSAPEQUA, NY 11758
Physician Assistant (Medical)
627 BROADWAY
MASSAPEQUA, NY 11758
Audiologist
627 BROADWAY
MASSAPEQUA, NY 11758
Specialist
627 BROADWAY
N MASSAPEQUA, NY 11758
Social Worker (Clinical)
627 BROADWAY, SUITE 200
MASSAPEQUA, NY 11758
Family Medicine
627 BROADWAY, SUITE 1
MASSAPEQUA, NY 11758

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 Sisselman Medical Group, PC's NPI number?

The NPI number for Sisselman Medical Group, PC is 1851572358. It was assigned to this organization in the NPPES registry on November 26, 2007.

Where is Sisselman Medical Group, PC located?

Sisselman Medical Group, PC is located at 627 Broadway Suite 1, Massapequa, NY 11758. The listed phone number is (516) 308-4040.

What is Sisselman Medical Group, PC's specialty?

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

Does Sisselman Medical Group, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1079653) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sisselman Medical Group, PC was last updated on October 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.