George W Sidrak, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB11236900 Issued in NJ

Practice address

852 Route 3
Clifton, NJ 07012-2343

Phone

(973) 450-1991

Fax

(973) 528-8009

NPI assigned

Mar 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: george.sidrak.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of New Jersey PA

  • Hospitalist Physician
  • Edison, NJ
  • NPI 1588021851

  Family Medicine

  Medicare reassignment NPD
• Jersey Irish Medical

  • Urgent Care Clinic/Center
  • Bound Brook, NJ
  • NPI 1144575739

  Family Medicine

  Medicare reassignment NPD
• NJ Acute Care Specialists Professional Corporation

  • Hospitalist Physician
  • East Orange, NJ
  • NPI 1073805917
  Medicare reassignment NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD

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

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1194283085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 ROUTE 3",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122343",
            "telephone_number": "973-450-1991",
            "fax_number": "973-528-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDRAK",
        "first_name": "GEORGE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-09",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB11236900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bijal S Sheth, MD
• Amjad Shono
• Caryn Shore-Genack, MS OTR/L
• Short Hills Ophthalmology LLC
• Tamara Shulman, PHD
• Elysa Renee Siegelheim, LPC
• Adrianna Sienkiewicz, LPC
• Andrea Carolina Sierra Borda, FNP-C
• Judy Gail Silber, M.D.
• Silen Surgicare Center, PA

• Family Medicine Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.