Sidus Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A11054 Issued in CA

Legal business name

SIDUS MEDICAL CORPORATION

Practice address

1041 E Yorba Linda Blvd
Suite 306
Placentia, CA 92870-3728

Phone

(714) 577-9500

Fax

(714) 577-9504

NPI assigned

Oct 5, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jason Matthew Kurtz, D.O.NPI 1104128552

Title

President

Phone

(714) 577-9500

Specialties & licenses 1

Addresses

Other names 1

• Yorba Linda Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Matthew Kurtz, D.O.

  • Internal Medicine Physician
  • Placentia, CA
  • NPI 1104128552
  Medicare reassignment Authorized official
• Tori Gorman

  • Physician Assistant
  • Placentia, CA
  • NPI 1730943119
  Medicare reassignment
• Madison Lee Helms, PA-C

  • Physician Assistant
  • Fullerton, CA
  • NPI 1922649649
  NPD (past)

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1245514595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD",
            "address_2": "SUITE 306",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703728",
            "telephone_number": "714-577-9500",
            "fax_number": "714-577-9504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD",
            "address_2": "SUITE 306",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703728",
            "telephone_number": "714-577-9500",
            "fax_number": "714-577-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDUS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "KURTZ",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-577-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yorba Linda Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Chang Shinen, O. D.
• Melanie Shinno, DPT
• Meena Shneezai
• Bradley Scott Shumway, PT
• Subha Shunmugam, SLP
• Heather Elizabeth Silva, LMFT
• Deanne Zeno Simmons, SLPA
• Sital Mandalia DDS Inc
• Elle Alexandra Skender, M.S. CCC-SLP
• Alfred W Sloan, MD

• Internal Medicine Physician in Placentia, CA
• Providers in Placentia, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.