Seamus M Siddall, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

T2010 Issued in AK

Practice address

200 A Street
Siddall Medical Services at Clear Afs
Clear Afs, AK 99704

Phone

(907) 585-6415

NPI assigned

Feb 12, 2009

Last updated

Aug 1, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21088/brand/1/csg/1/fhir/r4
• Direct secure messaging: seamus.siddall.1@21088.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Horizon Medical, Inc

  dba Canyon Clinic at Denali

  • Urgent Care Clinic/Center
  • Denali Park, AK
  • NPI 1770724510
  Medicare reassignment
• Siddall Medical Services, Inc.

  • Emergency Medicine Physician
  • Clear, AK
  • NPI 1467559138
  NPD (past)

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1376782458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 HILLSIDE DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997121643",
            "telephone_number": "907-750-5510",
            "fax_number": "907-585-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 A STREET",
            "address_2": "SIDDALL MEDICAL SERVICES AT CLEAR AFS",
            "city": "CLEAR AFS",
            "state": "AK",
            "postal_code": "99704",
            "telephone_number": "907-585-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDALL",
        "first_name": "SEAMUS",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-12",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "T2010",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AK",
            "license": "T2010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.