Individual provider Active NPI

Hasrat Sidhu, M.B.B.S

  • Internal Medicine Physician
  • Montgomery, AL
National Provider Identifier
1083277685
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47204 Issued in AL
Practice address
1725 Pine St
Montgomery, AL 36106-1117
Phone
(334) 293-8000
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.074075 IL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 47204 AL Primary

Addresses

Primary practice location

1725 Pine St
Montgomery, AL 36106-1117

Mailing address

3249 S. Oak Park Ave, Macneal Hospital
Berwyn, IL 60402

Other practice location 1

3722 Harlem Ave Ste Ll34
Riverside, IL 60546-2320
Phone (708) 783-6566

Other practice location 2

900 NW 17th St Fl 5
Miami, FL 33136-1119
Phone (305) 326-6170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306001247 AL Practitioner - Hospitalist 2769717305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Hospital and Clinic, IncGroup PAC ID 0547254153, 119 clinicians

Practice addresses (Care Compare)

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 293-8000

Hospital & facility affiliations

  • Amedisys Home Health of Montgomery Home health agency, Montgomery, AL, CCN 017319
  • Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47204ALMDInternal Medicine Physician
125.074075ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic, Inc. Internal Medicine Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Dec 10, 2023 Accepting new patients
Jackson Hospital and Clinic, Inc. CurrentSince Dec 10, 2023 Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients

Locations

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

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 2

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1083277685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 S. OAK PARK AVE, MACNEAL HOSPITAL",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061117",
            "telephone_number": "334-293-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3722 Harlem Ave Ste Ll34",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "IL",
            "postal_code": "605462320",
            "country_code": "US",
            "telephone_number": "708-783-6566",
            "fax_number": "708-783-6567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 NW 17th St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361119",
            "country_code": "US",
            "telephone_number": "305-326-6170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "HASRAT",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.074075",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "47204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.