Charles Sidwa, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

25MP00052400 Issued in NJ

Practice address

1322 Route 72 W
Suite 201
Manahawkin, NJ 08050

Phone

(800) 337-6663

NPI assigned

May 10, 2006

Last updated

Aug 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NJ Certified Dermatology PCGroup PAC ID 9931492287, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113

Merit-based Incentive Payment System (MIPS)

Final score

94.26 of 100Reported as group

Quality

93.24

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations (25 of 28)

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.

• NJ Certified Dermatology PC

  • Dermatology Physician
  • Neptune, NJ
  • NPI 1003263807
  Medicare reassignment Care Compare group NPD
• NJ Certified Dermatology PC

  dba Dedicated Dermatology

  • Dermatology Physician
  • Allentown, PA
  • NPI 1326496241
  NPD (past)

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

• HMH Hospitals Corporation

  dba Southern Ocean Medical Center

  • General Acute Care Hospital
  • Manahawkin, NJ
  • NPI 1831601590
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1295784734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 LAKEWOOD RD STE 16",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087553287",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 ROUTE 72 W",
            "address_2": "SUITE 201",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "08050",
            "telephone_number": "800-337-6663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 Route 72 W",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Manahawkin",
            "state": "NJ",
            "postal_code": "080502489",
            "country_code": "US",
            "telephone_number": "800-337-6663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDWA",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MP00052400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID/AMERIGROUP",
            "identifier": "320562",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K3524",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pamela Jean Simone, OTR
• Simply Timeless Beauty LLC (Simplicity Beauty Studio)
• Inderjit Singh, M.D.
• Ranbir Singh, MD
• Jillian Sinnamon, LMHC

• Dermatology Physician in Manahawkin, NJ
• Providers in Manahawkin, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.