Diane R Siedlecki, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD08079 Issued in RI

Practice address

180 Corliss St Ste B
Providence, RI 02904-2602

Phone

(401) 793-8400

Fax

(401) 793-8402

NPI assigned

Jun 27, 2005

Last updated

Oct 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: diane.siedlecki.1@10.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1265438923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CORLISS ST STE B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042602",
            "telephone_number": "401-793-8400",
            "fax_number": "401-793-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CORLISS ST STE B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042602",
            "telephone_number": "401-793-8400",
            "fax_number": "401-793-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEDLECKI",
        "first_name": "DIANE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD08079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane.siedlecki.1@10.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "180 Corliss St Ste B",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029042602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacqueline Sias
• Maarij Siddiqi, DO
• Aashir Siddique, DO
• Khizar Khalid Siddiqui, DMD
• Georgios Antonios Sideris, MD
• Cynthia Louise Siegel, CNM
• Nathan A Siegel, MD
• Sightrite Medical Ri LLC
• Mark Sigman, MD
• Guliana Signorelli

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.