Kanwaldeep Sidhu, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01066327 A Issued in IN

Practice address

10765 Lantern Road
Suite 102
Fishers, IN 46038-3597

Phone

(317) 621-4181

Fax

(317) 621-4182

NPI assigned

May 17, 2007

Last updated

Oct 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital East Hospital, Indianapolis, IN, CCN 150074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksidhu30962@ecommunitydirect.com
• Direct secure messaging: ksidhu483100@direct.parkviewexchange.com

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

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment Care Compare group NPD
• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Medicare reassignment NPD
• Community Howard Regional Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kokomo, IN
  • NPI 1881947133
  Medicare reassignment NPD
• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment NPD
• State of Indiana, Auditor of State

  dba Madison State Hospital

  • Psychiatric Hospital
  • Madison, IN
  • NPI 1700876224
  Medicare reassignment NPD
• Community Health Network, Inc

  dba Community Fairbanks Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1265477632
  NPD
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Parkview Health System, Inc.

  dba Parkview Physicians Group

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1952411233
  NPD
• State of Indiana, Auditor of State

  dba Indiana Department of Health

  • Public Health or Welfare Agency
  • Indianapolis, IN
  • NPI 1023613403
  NPD
• State of Indiana, Auditor of State

  dba NeuroDiagnostic Institute

  • Psychiatric Hospital
  • Indianapolis, IN
  • NPI 1043338684
  NPD
• Meridian Health Group

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Carmel, IN
  • NPI 1255409413
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665792000000",
    "number": "1033326947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10765 LANTERN ROAD",
            "address_2": "SUITE 102",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460383597",
            "telephone_number": "317-621-4181",
            "fax_number": "317-621-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10765 LANTERN ROAD",
            "address_2": "SUITE 102",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460383597",
            "telephone_number": "317-621-4181",
            "fax_number": "317-621-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "KANWALDEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-10-15",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01066327 A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000691248",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9676336",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01191777",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000637200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000721380",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000684780",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200944150",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksidhu30962@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Network, Inc",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksidhu483100@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1720 Beacon St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Shores, DPT
• Aimee Short, OTR/L
• Bradley Alan Shupe, DPT
• Cheryl Lynn Shutes, FNP
• Stephen Sicinski
• Kerrie Byrnes Siegl, LMFT
• Shawn P. Sigler, O.D.
• Terry Paul Silke, OD
• Luz Mireya Silva-Rueda
• Kelsy Marie Simanski, OTD, OTR

• Psychiatry Physician in Fishers, IN
• Providers in Fishers, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2022; 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.