NPIMap

Individual provider Active NPI

Stanley Carlos Sicher, MD

  • Nephrology Physician
  • Pueblo, CO
National Provider Identifier
1295733350
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
35746 Issued in CO
Practice address
3426 Lake Ave
120
Pueblo, CO 81004-3877
Phone
(719) 561-5264
Fax
(719) 561-5272
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 35746 CO Primary

Addresses

Primary practice location

3426 Lake Ave
120
Pueblo, CO 81004-3877

Mailing address

3426 Lake Ave
120
Pueblo, CO 81004-3877
Phone (719) 561-5264

Other identifiers 1

IdentifierTypeStateIssuer
01357466MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000378 CO Practitioner - NephrologyPractitioner - Internal Medicine 0345247482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Nephrology Assoc PCGroup PAC ID 5395636161, 7 clinicians

Practice addresses (Care Compare)

3426 Lake Ave
Suite 120
Pueblo, CO 81004-3878
Phone (719) 561-5264

Hospital & facility affiliations

  • 062520 Pueblo Dialysis (FMC) Dialysis facility, Pueblo, CO, CCN 062520
  • 062526 Walsenburg Dialysis (FMC) Dialysis facility, Walsenburg, CO, CCN 062526
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • Mt San Rafael Hospital Hospital, Trinidad, CO, CCN 061321
  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012

Merit-based Incentive Payment System (MIPS)

Final score
94.69 of 100Reported as group
Quality
70.43
Promoting interoperability
100
Improvement activities
40
Cost
78.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35746COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Nephrology Assoc PC CurrentSince Aug 1, 1997 Accepting new patients

Locations

3426 Lake Ave
Ste 120
Pueblo, CO 81004
Phone (719) 561-5264

Interoperability endpoints

  • Direct secure messaging: ssicher32129@direct.acumenmd.com

Organizations & group practices 1

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1295733350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3426 LAKE AVE",
            "address_2": "120",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043877",
            "telephone_number": "719-561-5264",
            "fax_number": "719-561-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3426 LAKE AVE",
            "address_2": "120",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043877",
            "telephone_number": "719-561-5264",
            "fax_number": "719-561-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICHER",
        "first_name": "STANLEY",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "35746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01357466",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.