Individual provider Active NPI

David G. Sidebottom, M.D.

  • Infectious Disease Physician
  • Lowell, MA
National Provider Identifier
1174580898
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
48047 Issued in MA
Practice address
275 Varnum Ave
Suite 203
Lowell, MA 01854-2109
Phone
(978) 934-9220
Fax
(978) 453-7771
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 48047 MA Primary

Addresses

Primary practice location

275 Varnum Ave
Suite 203
Lowell, MA 01854-2109

Mailing address

11 Outlook Rd
Wakefield, MA 01880-1415

Other practice location 1

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

Other identifiers 1

IdentifierTypeStateIssuer
3003191MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050328000477 MA Practitioner - Infectious Disease 5991751422 Reassigns benefits to 2 organizations
Practice locations: Lowell, MA

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of Massachusetts Medical School, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lowell Community Health Center, Inc.Group PAC ID 6204807944, 85 clinicians
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

101 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

365 E St
Tewksbury, MA 01876-1950

365 E St
Tewksbury, MA 01876-1998
Phone (978) 851-7321

Hospital & facility affiliations

  • Lowell General Hospital Hospital, Lowell, MA, CCN 220063

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Jul 31, 2025 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Jul 31, 2025 Accepting new patients
LGH Physician Associates, Inc Past Accepting new patients

Locations

365 East St
Tewksbury, MA 01876
Phone (617) 536-2186

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1174580898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 OUTLOOK RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE",
            "address_2": "SUITE 203",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542109",
            "telephone_number": "978-934-9220",
            "fax_number": "978-453-7771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018522103",
            "country_code": "US",
            "telephone_number": "978-937-9700",
            "fax_number": "978-221-6728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDEBOTTOM",
        "first_name": "DAVID",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "48047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003191",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.