Active NPI
Joseph A Sidaoui, M.D.
- Surgery Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 293644
- Practice address
- 27 Kingsland Ave Apt 2L
Brooklyn, NY 11211-1551 - Phone
- (407) 446-3323
- NPI assigned
- Jun 30, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 293644 | NY | |
| Surgery Physician | 208600000X | 293644 | NY | Primary |
Addresses
Primary practice location
27 Kingsland Ave Apt 2L
Brooklyn, NY 11211-1551
Mailing address
27 Kingsland Ave Apt 2L
Brooklyn, NY 11211-1551
Phone (407) 446-3323
Other practice location 1
506 Lenox Ave
Department of Surgery
New York, NY 10037-1802
Phone (212) 939-1000 ext. 1641
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05178872 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Hoaglands LN
Glen Head, NY 11545-2007
Phone (516) 603-2174
2 Medical PLZ
Glen Cove, NY 11542-2108
Phone (516) 740-9900
27 Kingsland Ave
Apt 2L
Brooklyn, NY 11211-1551
Phone (407) 446-3323
27 Kingsland Ave Apt
2L
Brooklyn, NY 11211-1551
2840 Knapp St
Brooklyn, NY 11235-1112
Phone (718) 646-5700
Hospital & facility affiliations
- M J H S Home Care
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 7908 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 293644 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chopra Physician PLLC | Current | Accepting new patients | |
| Renew Medical of New York, PLLC | Current | Accepting new patients | |
| Sidaoui Corp | Surgery | Current | Accepting new patients |
Locations
691 92nd St
Brooklyn, NY 11228
Phone (718) 567-1000
2840 Knapp St
Brooklyn, NY 11235
Phone (516) 405-6700
3923 Fort Hamilton Pkwy
Brooklyn, NY 11218
Phone (718) 314-0999
1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110
11126 Corona Ave
Flushing, NY 11368
Phone (718) 592-6400
320 W Merrick Rd
Freeport, NY 11520
Phone (516) 377-2946
6135 Dry Harbor Rd
Middle Vlg, NY 11379
Phone (718) 505-7500
100 Southern Blvd
Nesconset, NY 11767
Phone (631) 361-8100
385 Seneca Ave
Ridgewood, NY 11385
Phone (201) 843-7574
1146 Woodcrest Ave
Riverhead, NY 11901
Phone (631) 727-4400
255 Warner Ave
Roslyn Hts, NY 11577
Phone (516) 621-5400
8533 Jericho Tpke
Woodbury, NY 11797
Phone (516) 692-4100
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.
-
- Long Term Care Hospital
- Plainview, NY
- NPI 1053617712
-
- Surgery Physician
- Brooklyn, NY
- NPI 1164052908
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1356979447
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- New York, NY
- NPI 1720019144
-
- Home Health Agency
- Brooklyn, NY
- NPI 1710149984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1346680790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 KINGSLAND AVE APT 2L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112111551",
"telephone_number": "407-446-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 KINGSLAND AVE APT 2L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112111551",
"telephone_number": "407-446-3323"
}
],
"practiceLocations": [
{
"address_1": "506 Lenox Ave",
"address_2": "Department of Surgery",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100371802",
"country_code": "US",
"telephone_number": "212-939-1000 x1641",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIDAOUI",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-30",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "293644",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "293644",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05178872",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.