Individual provider Active NPI

Algis Petras Sidrys, M.D.

  • Radiation Oncology Physician
  • Cookeville, TN
National Provider Identifier
1104873090
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
28008 Issued in TN
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone
(931) 783-2497
Fax
(931) 783-5757
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 28008 TN Primary
Hematology & Oncology Physician 207RH0003X 28008 TN

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-4294

Mailing address

140 W 7TH St
Cookeville, TN 38501-1726
Phone (931) 783-5582

Other identifiers 2

IdentifierTypeStateIssuer
3806863MedicaidTN
3806864MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090701000156 TN Practitioner - Radiation Oncology 4385682384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Loyola University of Chicago, Stritch School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Regional Medical CenterGroup PAC ID 7810805736, 51 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 783-2497

Hospital & facility affiliations

  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score
31.93 of 100Reported as individual
Quality
30
Improvement activities
0
Cost
58.78

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
55.01
Promoting interoperability
97
Improvement activities
40
Cost
75.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cookeville Regional Medical Center Hematology & Oncology CurrentSince Sep 1, 2006 Accepting new patients
Upper Cumberland Oncology Radiation Oncology CurrentSince Apr 17, 2006 Accepting new patients
Upper Cumberland Oncology Current Accepting new patients
Cookeville Regional Medical Center CurrentSince Sep 1, 2006 Accepting new patients

Locations

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

142 W 5th St
Cookeville, TN 38501
Phone (931) 520-2662

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

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 1

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1104873090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 7TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011726",
            "telephone_number": "931-783-5582",
            "fax_number": "931-526-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2497",
            "fax_number": "931-783-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDRYS",
        "first_name": "ALGIS",
        "middle_name": "PETRAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "28008",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "28008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3806863",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3806864",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.