Mandeep Kaur Sidhu, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

281017 Issued in AZ

Practice address

4220 N 20TH Ave
Phoenix, AZ 85015-5124

Phone

(623) 872-1818

Fax

(623) 872-1819

NPI assigned

Sep 19, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

All Family Care PCGroup PAC ID 6406867936, 3 clinicians

Healing Edge Recovery and Wellness CenterGroup PAC ID 4082143680, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJBAA/Endpoint/CCJBAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healing Edge Recovery and Wellness Center

  • Adult Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1790553329

  Single Specialty

  Medicare reassignment Care Compare group NPD
• All Family Care, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1801864277
  Medicare reassignment Care Compare group
• MD Homecare LLC

  • Health Service Psychologist
  • Phoenix, AZ
  • NPI 1720524333
  Medicare reassignment
• Umbrella Medical LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1861202335

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1003538844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11836 N 96TH PL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605962",
            "telephone_number": "480-798-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155124",
            "telephone_number": "623-872-1818",
            "fax_number": "623-872-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "MANDEEP",
        "middle_name": "KAUR",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "281017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Sidebottom, FNP
• Lawrence Mark Sideman, PH.D.
• Scot Michael Sidener, COTA L
• Jagdeep Sidhu, M.D.
• Jiten Sidhu, PHARM.D.
• Sandeep Sidhu, MD
• Upinder Singh Sidhu, MD
• Ibrahim H Sidiqi, MD
• Malia Sidler, CF-SLP
• Kelly Sidlinger, CRNA

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.