Shawn Sidharthan, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25MA12047200 Issued in NJ

Practice address

596 Anderson Ave Ste 216
Cliffside Park, NJ 07010-1856

Phone

(201) 772-2329

NPI assigned

Mar 28, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

NeurologyAlso: Pain Management

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pain Physicians Ny PLLCGroup PAC ID 3870779143, 6 clinicians

Premier Brain and Spine LLCGroup PAC ID 6608264833, 128 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: ssidharthan67063@northwell.direct-ci.com
• Direct secure messaging: ssidharthan423765@christushealth.direct-ci.net

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.

• Premier Brain and Spine, LLC

  • Neurological Surgery Physician
  • Union, NJ
  • NPI 1922771377

  Interventional Pain Medicine

  Medicare reassignment Care Compare group NPD
• Pain Physicians Ny PLLC

  • Interventional Pain Medicine Physician
  • New York, NY
  • NPI 1538465497
  Medicare reassignment Care Compare group NPD
• BL Pain Management PLLC

  • Interventional Pain Medicine Physician
  • Bronx, NY
  • NPI 1922509769
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Premier Brain and Spine LLC

  • Durable Medical Equipment & Medical Supplies
  • Shrewsbury, NJ
  • NPI 1427944156
  NPD
• BL Pain Management PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bronx, NY
  • NPI 1821888165
  NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Big Leap Medical Group PA

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1821841503
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1356617997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MATAWAN RD STE 302",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472653",
            "telephone_number": "732-441-7177",
            "fax_number": "732-441-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE STE 216",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101856",
            "telephone_number": "201-772-2329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1976 Crotona Pkwy Ste 3A",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104601526",
            "country_code": "US",
            "telephone_number": "718-645-2829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "956-739-2742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDHARTHAN",
        "first_name": "SHAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "281570-1",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA12047200",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA12047200",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "281570-1",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "281570-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Shawn.Sidharthan.1@21449.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Premier Brain and Spine, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "596 Anderson Ave Ste 216",
            "city": "Cliffside Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070101856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lynn Shin
• Eleonora Sholomova, OTA
• Anita Shulman, DDS
• Mikhail Shulman, DDS
• Nataliya Shvarshteyn, RPH
• Daniela M Simancas-Parejo, PT, DPT
• Timothy L Simansky, D.C.
• Mary Jo Mule' Simeone, CCC-SLP
• Robert Bradley Simon, MD
• Edith L Slater, LCSW

• Neurology Physician in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.

Verify at the official NPI Registry.