NPIMap

Individual provider Active NPI

Brian J Sidone, PHARMD

  • Pharmacist
  • Ebensburg, PA
National Provider Identifier
1083990220
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP445592 Issued in PA
Practice address
3720 New Germany Rd
Ebensburg, PA 15931
Phone
(814) 472-9390
Fax
(814) 472-1166
NPI assigned
Nov 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X PA
Health Educator 174H00000X PA
Pharmacist 183500000X RP445592 PA Primary

Addresses

Primary practice location

3720 New Germany Rd
Ebensburg, PA 15931

Mailing address

PO Box 58
Ebensburg, PA 15931-0058
Phone (814) 472-9390

Other practice location 1

1049 Shoemaker St
Nanty Glo, PA 15943-1248
Phone (814) 419-6717

Other practice location 2

135 E Market St Ste 100
Blairsville, PA 15717-1369
Phone (724) 459-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
3JB LLC Addiction (Substance Use Disorder) Past Accepting new patients
Mainline Pharmacy Ebensburg LLC Addiction (Substance Use Disorder) Past Accepting new patients
Mopa Group, LLC PastSince May 25, 2025 Accepting new patients
3JB LLC Past Accepting new patients
Mainline Pharmacy Ebensburg, LLC Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083990220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159310058",
            "telephone_number": "814-472-9390",
            "fax_number": "814-472-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 NEW GERMANY RD",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "15931",
            "telephone_number": "814-472-9390",
            "fax_number": "814-472-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1049 Shoemaker St",
            "address_purpose": "LOCATION",
            "city": "Nanty Glo",
            "state": "PA",
            "postal_code": "159431248",
            "country_code": "US",
            "telephone_number": "814-419-6717",
            "fax_number": "814-419-6719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 E Market St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Blairsville",
            "state": "PA",
            "postal_code": "157171369",
            "country_code": "US",
            "telephone_number": "724-459-7400",
            "fax_number": "724-459-8207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDONE",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP445592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.