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Deactivated NPI 1619904182 Deactivated / Inactive NPI Male Practitioner

Dr. Vergil Duane Sisson , MD

General Practice • San Bernardino, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Vergil Sisson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 28, 2006
NPI Deactivation Date June 01, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Vergil Sisson, MD was a registered General Practice practicing in San Bernardino, CA. Throughout an active medical career spanning 14 years, Dr. Sisson provided care at the practice location at 330 N D ST until profile deactivation on 2020-06-01.

Historical Medicare Part B clinical services included established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

330 N D St
Ste 300

San Bernardino, CA 924011522

Telephone 9098886602
Fax 9098857494
Associated Practice Facility / Clinic
🏢 Hoa Vu Md Inc Facility NPI 1710284427

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in San Bernardino, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 52.0 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
11 Specialists

Practicing in San Bernardino, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
25.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
16 14 $95.00 $70.43

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License CA C27156

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1356359277

Doctor of Medicine (M.D.)

Ezequiel Martinez , PA

Physician Assistant - Medical

NPI 1497822142

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 01, 2020

Record deactivated on June 01, 2020

NPI Profile Active February 24, 2016

NPI status registered as active in NPPES database

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Updated Practice Location February 24, 2016

Registered at 330 N D ST, STE 300, SAN BERNARDINO, CA 924011522 (Tel: 9098886602)

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Updated Business Mailing Address February 24, 2016

Registered at 330 N D ST, STE 300, SAN BERNARDINO, CA 924011522 (Tel: 9099159750)

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Provider Name / Credentials Updated February 24, 2016

Recorded as VERGIL SISSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2016

General Practice (License #C27156 in CA)

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Initial NPI Registration & Enumeration June 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619904182
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 28, 2006
Last Update: February 24, 2016
Deactivation Date: June 01, 2020

Mailing Address

330 N D St, Ste 300

San Bernardino, CA 924011522

Phone: 9099159750

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.