Ryan Sidebottom, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8251 Issued in AZ

Practice address

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Phone

(602) 933-0985

Fax

(602) 933-2442

NPI assigned

Oct 30, 2015

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 1

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment Care Compare group NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1679703441
  NPD
• Phoenician Hospice LLC

  • Community Based Hospice Care Agency
  • Scottsdale, AZ
  • NPI 1730624461
  NPD (past)

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1104298090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0985",
            "fax_number": "602-933-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEBOTTOM",
        "first_name": "RYAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075841",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gamal F Sidarous, MD
• Rajiv Siddaramu, MD
• Mehtab Fatima Siddiky, M.D
• Fatima Siddiqi, AGACNP
• Rebecca Siddiqui
• Lawrence Mark Sideman, PH.D.
• Scot Michael Sidener, COTA L
• Jagdeep Sidhu, M.D.
• Jiten Sidhu, PHARM.D.
• Mandeep Kaur Sidhu, PMHNP

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.