NPIMap

Individual provider Active NPI

Eugene John Sidoti Jr., M.D.

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1316958945
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
59440 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
Fax
(602) 344-5596
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 175407 NY
Plastic Surgery Physician 208200000X 175407 NY
Plastic Surgery Physician 208200000X 59440 AZ
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 175407 NY
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 59440 AZ
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 175407 NY
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 59440 AZ
Plastic and Reconstructive Surgery Physician 2086S0122X 175407 NY
Plastic and Reconstructive Surgery Physician 2086S0122X 59440 AZ Primary

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other practice location 1

688 Post Rd Ste 220
Suite 220
Scarsdale, NY 10583-5015
Phone (914) 472-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200106001127 AZ Practitioner - Plastic and Reconstructive Surgery 8628257441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

3141 N 3Rd Ave
Phoenix, AZ 85013-4360
Phone (602) 914-1520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59440AZMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
175407NYMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eugene J Sidoti Jr MD PC Current Accepting new patients
District Medical Group, Inc CurrentSince Nov 7, 2019 Accepting new patients
District Medical Group, Inc CurrentSince Nov 7, 2019 Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients
Quarry Road Emergency Services P.C. Past Accepting new patients

Locations

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

688 White Plains Rd
Ste 220
Scarsdale, NY 10583
Phone (914) 472-7200

Interoperability endpoints

  • Direct secure messaging: esidoti215578@direct.valleywisehealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 12

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1316958945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011",
            "fax_number": "602-344-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "688 Post Rd Ste 220",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105835015",
            "country_code": "US",
            "telephone_number": "914-472-7200",
            "fax_number": "914-472-7527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDOTI",
        "first_name": "EUGENE",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "175407",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "175407",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "59440",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "175407",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "AZ",
            "license": "59440",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "175407",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "AZ",
            "license": "59440",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "175407",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "59440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.