Sidra Anis

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00645300 Issued in NJ

Practice address

904 Bayonne Crossing Way
Bayonne, NJ 07002-5307

Phone

(551) 497-5675

Fax

(551) 497-5676

NPI assigned

Jun 20, 2019

Sex

Female

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 NY, NJ, CT3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sidra.anis.1@2983.direct.athenahealth.com
• Direct secure messaging: sidra.anis.2@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

  NJ

  Medicare reassignment NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • Norwalk, CT
  • NPI 1851132831

  CT

  Medicare reassignment NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1801277629

  NY

  Medicare reassignment
• Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
  • NPI 1285975797

  NY

  Medicare reassignment
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1740913763
  NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • Bellmore, NY
  • NPI 1982903506
  NPD

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1225698202",
    "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": "904 BAYONNE CROSSING WAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025307",
            "telephone_number": "551-497-5675",
            "fax_number": "551-497-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIS",
        "first_name": "SIDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00645300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Amilcar, MS CCC-SLP
• Madhat S Amin I
• Saba M Anaam
• Andrea a. Flores D.C.,LLC
• Robert A. Angelica, D.D.S.
• Anisah Miley LCSW PLLC
• Anna V. Kopec, MD
• Ayesha Ansari, M. ASLP
• Gregory Dominick Anselmi, M.D.
• Apollo Medical Trans Inc

• All providers in Bayonne, NJ
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.