Active NPI
Sidak Pannu, M.D.
- Vascular & Interventional Radiology Physician
- Springfield, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 1014931
- Practice address
- 3500 Main St Ste 201
Springfield, MA 01107-1150 - Phone
- (413) 794-0900
- Fax
- (413) 794-2996
- NPI assigned
- Apr 12, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 22677 | NH | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 1014931 | MA | Primary |
Addresses
Primary practice location
3500 Main St Ste 201
Springfield, MA 01107-1150
Mailing address
280 Chestnut Street
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- George Washington University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3500 Main St
Springfield, MA 01107-1137
Phone (413) 794-0900
Hospital & facility affiliations
- Baystate Medical Center
- Baystate Noble Hospital
- Baystate Franklin Medical Center
- Baystate Wing Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22677 | NH | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baystate Medical Practices, Inc | Current | Accepting new patients | |
| Dartmouth-Hitchcock Clinic | Diagnostic Radiology | Current | Accepting new patients |
Locations
3500 Main St
Ste 201
Springfield, MA 01107
Phone (413) 784-0900
759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233
3500 Main St
Springfield, MA 01107
Phone (413) 784-0900
280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385
1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922
Organizations & group practices 2
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Springfield, MA
- NPI 1548205909
-
- Internal Medicine Physician
- Lebanon, NH
- NPI 1548210198
Diagnostic Radiology
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Greenfield, MA
- NPI 1508867391
-
- General Acute Care Hospital
- Springfield, MA
- NPI 1487655064
-
- General Acute Care Hospital
- Westfield, MA
- NPI 1700816048
-
- General Acute Care Hospital
- Palmer, MA
- NPI 1962410233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1326402728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 CHESTNUT STREET",
"address_2": "2ND FLOOR",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011991001",
"telephone_number": "413-794-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 MAIN ST STE 201",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071150",
"telephone_number": "413-794-0900",
"fax_number": "413-794-2996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNU",
"first_name": "SIDAK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-12",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NH",
"license": "22677",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "MA",
"license": "1014931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.