Individual provider Active NPI

Joseph A Sidaoui, M.D.

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1346680790
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
293644 Issued in NY
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

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
05178872MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414002702 NY Practitioner - General Surgery 6608119375 Reassigns benefits to 3 organizations

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
Chopra Physician PLLCGroup PAC ID 3971786765, 2 clinicians

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 Home health agency, Brooklyn, NY, CCN 337061

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue7908

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
293644NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chopra Physician PLLC CurrentSince Jun 1, 2021 Accepting new patients
Renew Medical of New York, PLLC CurrentSince Dec 1, 2020 Accepting new patients
Sidaoui Corp Surgery CurrentSince Jan 1, 2020 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.

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": "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

Verify at the official NPI Registry.