Individual provider Active NPI

Sidneia M. Sharif, NP-C

  • Nurse Practitioner
  • Summit, NJ
National Provider Identifier
1306109152
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00389600 Issued in NJ
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(908) 522-5329
Fax
(908) 598-5453
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00389600 NJ
Gerontology Nurse Practitioner 363LG0600X 26NJ00389600 NJ
Nurse Practitioner 363L00000X 26NJ00389600 NJ Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130218000368 NJ Practitioner - Nurse Practitioner 4183878366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00389600NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fellowship Village Inc. CurrentSince Jul 27, 2018 Accepting new patients
Practice Associates Medical Group CurrentSince Jan 4, 2014 Accepting new patients
Fellowship Senior Living, Inc. Adult Health CurrentSince Jul 27, 2018 Accepting new patients

Locations

8000 Fellowship Rd
Basking Ridge, NJ 07920
Phone (908) 580-3800

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • Direct secure messaging: ssharif101598@direct.ahsys.org
  • FHIR API: https://api.platform.athenahealth.com/19916/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1306109152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-5329",
            "fax_number": "908-598-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIF",
        "first_name": "SIDNEIA",
        "middle_name": "M.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00389600",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00389600",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00389600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.