JILL SISSELMAN (NPI# 1295895480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295895480 |
| Entity Type | Individual |
| Full Name | JILL SISSELMAN |
| Credential | D.O. |
| Practice Address |
627 Broadway Suite 1 Massapequa NY 11758-5031 |
| Practice Telephone | 5163084040 |
| Practice Fax Number | 5168046386 |
| Mailing Telephone | 5163084040 |
| Mailing Fax Number | 5168046386 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2014-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 216154 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
627 BROADWAY SUITE 1 |
| City | MASSAPEQUA |
| State | NY |
| Zip Code | 11758-5031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104811421 | John Edward Rooney | Allergy & Immunology | 627 Broadway, Massapequa, NY 11758-5031 | 2005-09-13 |
| 1083904494 | Amy L Roberts | Physician Assistant | 627 Broadway, Suite 1, Massapequa, NY 11758-5031 | 2011-04-19 |
| 1730488941 | Mary K Paul | Allergy & Immunology | 627 Broadway, Massapequa, NY 11758 | 2011-03-28 |
| 1851572358 | Sisselman Medical Group, PC | Family Medicine | 627 Broadway, Suite 1, Massapequa, NY 11758-5031 | 2007-11-26 |
| 1629286521 | Donna Marie Carson | Social Worker | 627 Broadway, Massapequa, NY 11758-5031 | 2007-05-21 |
| 1134259716 | Bruce Nyfield | Psychologist | 627 Broadway, Suite 201, Massapequa, NY 11258 | 2007-03-06 |
| 1558405977 | Maryann Leone | Psychologist | 627 Broadway, Suite Maidat, Massapequa, NY 11758-5031 | 2007-02-18 |
| 1437299690 | Bonnie G Weintraub | Social Worker | 627 Broadway, Ste.200, Massapequa, NY 11758-5031 | 2007-02-07 |
| 1194873372 | Barbara Ann Kilgus | Social Worker | 627 Broadway, Suite 200, Massapequa, NY 11758-5031 | 2007-01-06 |
| 1497822787 | Keith Robert Gonsor | Psychologist | 627 Broadway, Suite 200, Massapequa, NY 11758-5031 | 2006-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535339 | Jamie Leigh Disilvio | Licensed Practical Nurse | 24 Amity Pl., Massapequa, NY 11758 | 2019-12-16 |
| 1548787955 | June H Friedman | Social Worker | 78 North Pine Street, North Massapequa, NY 11758 | 2017-08-25 |
| 1376078568 | Caitlin Bree Kennedy | Acupuncturist | 507 Hicksville Road, Massapequa, NY 11758 | 2017-04-25 |
| 1932645561 | Maria Amato | Specialist | 277 Division Ave, Massapequa, NY 11758 | 2017-01-06 |
| 1164877270 | Marylou Lawson | Early Intervention Provider Agency | 87 N Pine Street, N Massapequa, NY 11758 | 2016-04-26 |
| 1417314196 | Tender Heart Senior Care Corp | In Home Supportive Care | 24 Peconic Dr, Massapequa, NY 11758 | 2016-01-26 |
| 1316328420 | Theresa Mackey | Behavioral Analyst | 19 Oxford Avenue, N. Massapequa, NY 11758 | 2015-06-15 |
| 1932596590 | Bianca Ferrantelli | Specialist | 13 Alhabra Rd, Apt 5, Massapequa, NY 11758 | 2015-04-22 |
| 1245625797 | Medwell Medical PC | Pain Medicine | 1065a North Broadway, Massapequa, NY 11758 | 2015-04-01 |
| 1053703926 | Joseph Sgaglione | Physical Therapist | 503 Wright Drive, Massapequa, NY 11758 | 2015-03-02 |
| Find all providers in zip 11758 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972661155 | Stuart Horowitz | Family Medicine | 99 Grand Ave, Massapequa, NY 11758-1203 | 2006-12-04 |
| 1154493294 | James W Atkinson | Family Medicine | 9a Broadway, Massapequa, NY 11758 | 2006-11-14 |
| 1386750206 | Catherine L Ferrara | Family Medicine | 20 Unqua Rd, Massapequa, NY 11758-6727 | 2006-08-22 |
| 1487626289 | Richard John Bebirian | Family Medicine | 1 Carman Gate, Massapequa, NY 11758 | 2006-02-06 |
| 1205831435 | Marjorie J. Isdith | Family Medicine | 20 Hicksville Road, Massapequa, NY 11758 | 2005-06-15 |
| 1568827103 | Nancy Leventhal | Family Medicine | 1061 N Broadway, Massapequa, NY 11758-1853 | 2015-12-28 |
| 1720253487 | Marjorie J Isdith Do PC | Family Medicine | 20 Hicksville Rd, Suite 5, Massapequa, NY 11758-5819 | 2008-04-24 |
| 1851572358 | Sisselman Medical Group, PC | Family Medicine | 627 Broadway, Suite 1, Massapequa, NY 11758-5031 | 2007-11-26 |
| 1033265244 | Teresa Esposito | Family Medicine | 848 Hicksville Rd, Massapequa, NY 11758-1210 | 2007-01-28 |
| 1902969033 | Cardiology & Internal Medicine of Long Island | Family Medicine | 510 Hicksville Rd, Massapequa, NY 11758-1203 | 2006-12-19 |
| Find all providers in MASSAPEQUA | ||||
| City | MASSAPEQUA |
| Zip Code | 11758 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.