Individual provider Active NPI

Sidharth G Sharma, MD

  • Psychiatry Physician
  • San Ramon, CA
National Provider Identifier
1396069050
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16901 Issued in NV
Practice address
2305 Camino Ramon Ste 221
San Ramon, CA 94583-1316
Phone
(925) 624-4069
NPI assigned
Mar 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16901 NV Primary

Addresses

Primary practice location

2305 Camino Ramon Ste 221
San Ramon, CA 94583-1316

Mailing address

4270 S Decatur Blvd
Ste B6
Las Vegas, NV 89103-6802
Phone (702) 485-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20210329001334 NJ Practitioner - Psychiatry 5395033542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rutgers New Jersey Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of EssexGroup PAC ID 7214837061, 11 clinicians

Practice addresses (Care Compare)

204 Grove Ave
Cedar Grove, NJ 07009-1436
Phone (973) 571-2833

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16901NVMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Essex Current Accepting new patients
County of Essex Psychiatry CurrentSince Mar 1, 2021 Accepting new patients
County of Essex CurrentSince Mar 1, 2021 Accepting new patients
County of Essex Current Accepting new patients
Vortex Psychiatry, Inc. Psychiatry Past Accepting new patients

Locations

204 Grove Ave
Cedar Grove, NJ 07009
Phone (973) 571-2800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1396069050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD",
            "address_2": "STE B6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-485-2100",
            "fax_number": "702-825-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CAMINO RAMON STE 221",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831316",
            "telephone_number": "925-624-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SIDHARTH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "16901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.