Active NPI
Sunita Sidhu-Buonocore, MD
- Gastroenterology Physician
- Norwich, CT
National Provider Identifier
1316264286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 48684
- Practice address
- 79 Wawecus St
Suite 101
Norwich, CT 06360-2160 - Phone
- (860) 886-2655
- Fax
- (860) 887-9003
- NPI assigned
- Apr 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 48684 | CT | Primary |
Addresses
Primary practice location
79 Wawecus St
Suite 101
Norwich, CT 06360-2160
Mailing address
79 Wawecus St
Suite 101
Norwich, CT 06360-2160
Phone (860) 886-2655
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D400021782 | Other | MEDICARE PTAN | |
| P4244379 | Other | CT | OXFORD |
| P01052399 | Other | MEDICARE RAILROAD | |
| 9593541 | Other | CT | AETNA |
Other names 1
- Sunita Sidhu
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48684 | CT | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1316264286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 WAWECUS ST",
"address_2": "SUITE 101",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602160",
"telephone_number": "860-886-2655",
"fax_number": "860-887-9003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 WAWECUS ST",
"address_2": "SUITE 101",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602160",
"telephone_number": "860-886-2655",
"fax_number": "860-887-9003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDHU-BUONOCORE",
"first_name": "SUNITA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-30",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CT",
"license": "48684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "D400021782",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P4244379",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P01052399",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9593541",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUNITA",
"last_name": "SIDHU",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.