BENJAMIN SISIC (RD, LD) – Registered Dietitian, NPI 1578241618

BENJAMIN SISIC (RD, LD) is a healthcare provider. based in Woodstock, Georgia. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD, LD. They hold a License No. LD004467 (GA). The NPI Number for BENJAMIN SISIC (RD, LD) is 1578241618

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
BENJAMIN SISIC (RD, LD)
NPI
1578241618
Phone
(678) 865-9922
Address
278 BALABAN CIR
Enumeration Date
10 July 2023
Last Update Date
10 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6785547576
Graduation Year
2012 (14 years ago)
PAC ID
6002259710
Group Practice PAC ID
7315371127
Professional Enrollment ID
I20240209002202
Address ID
GA300046017AL1802XCTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

115 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in GA

Provider Addresses for BENJAMIN SISIC (RD, LD)

  • 278 BALABAN CIR

    WOODSTOCK, GA 301885150

    Phone: (678) 865-9922

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240209002202IRegistered Dietitian Or Nutrition ProfessionalGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30188)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315371127View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalGA
Registered Dietitian Or Nutrition ProfessionalGA
Registered Dietitian Or Nutrition ProfessionalTX
Registered Dietitian Or Nutrition ProfessionalNC
Registered Dietitian Or Nutrition ProfessionalNC

Reviews

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Frequently asked questions

What is the registry number for BENJAMIN SISIC (RD, LD)?
The registry entry for BENJAMIN SISIC (RD, LD) shows NPI 1578241618.
Does the public listing show BENJAMIN SISIC (RD, LD) as active?
BENJAMIN SISIC (RD, LD)'s NPI record reflects an active status in NPPES.
How should patients interpret BENJAMIN SISIC (RD, LD)'s specialty?
The extract shows Registered Dietitian for BENJAMIN SISIC (RD, LD). Clinical services aligned with this taxonomy classification.
What geographic area is tied to BENJAMIN SISIC (RD, LD)?
BENJAMIN SISIC (RD, LD) is associated with Woodstock, Georgia in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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