Individual provider Active NPI

Richard C Sipe, PA-C

  • Physician Assistant
  • Brunswick, GA
National Provider Identifier
1326280280
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3231 Glynn Ave
Brunswick, GA 31520-4851
Phone
(912) 265-9006
Fax
(912) 554-3636
NPI assigned
Mar 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3231 Glynn Ave
Brunswick, GA 31520-4851

Mailing address

3231 Glynn Ave
Brunswick, GA 31520-4851
Phone (912) 265-9006

Other identifiers 2

IdentifierTypeStateIssuer
GRP3915OtherGAMEDICARE GROUP NUMBER
357432493AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20090622000325 GA Practitioner - Physician Assistant 8921159534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optim Orthopedics LLCGroup PAC ID 9931427002, 101 clinicians

Practice addresses (Care Compare)

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

3231 Glynn Ave
Brunswick, GA 31520-4851
Phone (912) 342-7112

Hospital & facility affiliations

  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optim Orthopedics, LLC CurrentSince Nov 1, 2024 Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients

Locations

3231 Glynn Ave
Brunswick, GA 31520
Phone (912) 265-9006

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

Interoperability endpoints

  • Direct secure messaging: richard.sipe.1@16403.direct.athenahealth.com

Organizations & group practices 7

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 2

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247788800000",
    "number": "1326280280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204851",
            "telephone_number": "912-265-9006",
            "fax_number": "912-554-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204851",
            "telephone_number": "912-265-9006",
            "fax_number": "912-554-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPE",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP3915",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357432493A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.