Individual provider Active NPI

Reem M Sidani, MD

  • Family Medicine Physician
  • Ellenwood, GA
National Provider Identifier
1417584491
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
97088 Issued in GA
Practice address
211 Fairview Rd
Ellenwood, GA 30294-2721
Phone
(678) 289-6747
Fax
(678) 289-6750
NPI assigned
Mar 27, 2020
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 97088 GA Primary

Addresses

Primary practice location

211 Fairview Rd
Ellenwood, GA 30294-2721

Mailing address

3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20231027001535 GA Practitioner - Family Practice 5395167993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

211 Fairview Rd
Ellenwood, GA 30294-2721
Phone (770) 914-0116

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Family Medicine CurrentSince Sep 18, 2023 Accepting new patients
Aylo Health, LLC CurrentSince Sep 18, 2023 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

211 Fairview Rd
Ellenwood, GA 30294
Phone (678) 289-6747

1058 Bear Creek Blvd
Hampton, GA 30228
Phone (770) 707-0808

1502 W 3rd St
Ste A
Jackson, GA 30233
Phone (678) 774-0430

3758 Highway 42 S
Locust Grove, GA 30248
Phone (678) 561-9430

3758 Highway 42 S
Ste 200
Locust Grove, GA 30248
Phone (678) 374-7514

65 Old Jackson Rd
McDonough, GA 30252
Phone (678) 490-0080

1100 Hospital Dr
Stockbridge, GA 30281
Phone (678) 432-6161

1240 Eagles Landing Pkwy
Ste 110
Stockbridge, GA 30281
Phone (770) 389-3855

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

Interoperability endpoints

  • Direct secure messaging: reem.sidani@elfp.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1417584491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942721",
            "telephone_number": "678-289-6747",
            "fax_number": "678-289-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDANI",
        "first_name": "REEM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "97088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.