Individual provider Active NPI

Richard Sidwell, MD

  • Surgery Physician
  • Des Moines, IA
National Provider Identifier
1063407195
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD-32345 Issued in IA
Practice address
1212 Pleasant St
Suite 211
Des Moines, IA 50309
Phone
(515) 875-9770
Fax
(515) 875-9771
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD-32345 IA Primary

Addresses

Primary practice location

1212 Pleasant St
Suite 211
Des Moines, IA 50309

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

Other identifiers 1

IdentifierTypeStateIssuer
2170316MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address richardsidwell@tic.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20100125000313 IA Practitioner - General Surgery 9537201884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

1212 Pleasant St
Suite 211
Des Moines, IA 50309-1411
Phone (515) 875-9100

Hospital & facility affiliations

  • Unitypoint Health - Des Moines Iowa Methodist Medi Hospital, Des Moines, IA, CCN 160082
  • Dallas County Hospital Hospital, Perry, IA, CCN 161322
  • Humboldt County Memorial Hospital Hospital, Humboldt, IA, CCN 161334

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-32345IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic PC Surgery CurrentSince Jun 1, 2001 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
The Iowa Clinic, PC CurrentSince Jun 1, 2001 Accepting new patients
Central Iowa Hospital Corporation Past Accepting new patients

Locations

509 N Madison St
Bloomfield, IA 52537
Phone (641) 664-2145

1801 Hickman Rd
Bldg First
Des Moines, IA 50314

1212 Pleasant St
Ste 211DT
Des Moines, IA 50309

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1212 Pleasant St
Ste 211
Des Moines, IA 50309
Phone (515) 875-9770

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

5950 University Ave
Ste 175
West Des Moines, IA 50266
Phone (515) 875-9908

6800 Lake Dr
Ste 250
West Des Moines, IA 50266

Interoperability endpoints

  • Direct secure messaging: rsidwell9891@direct.unitypoint.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1063407195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PLEASANT ST",
            "address_2": "SUITE 211",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50309",
            "telephone_number": "515-875-9770",
            "fax_number": "515-875-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDWELL",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "MD-32345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2170316",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richardsidwell@tic.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1212 Pleasant St",
            "address_2": "Suite 211",
            "city": "Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.