Kelly Siudzinski, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M-9339 Issued in ID

Practice address

2273 E Gala St
Suite 110
Meridian, ID 83642-7289

Phone

(208) 994-5700

Fax

(208) 994-5700

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.siudzinski@269680668311556.direct.elationemr.com

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.

• Women'S Health Associates, PLLC

  • Obstetrics & Gynecology Physician
  • Boise, ID
  • NPI 1013957885
  NPD

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1417906405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2273 E GALA ST",
            "address_2": "SUITE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427289",
            "telephone_number": "208-994-5700",
            "fax_number": "208-994-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 E GALA ST",
            "address_2": "SUITE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427289",
            "telephone_number": "208-994-5700",
            "fax_number": "208-994-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIUDZINSKI",
        "first_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-9339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sirucek Chiropractic Neurology Clinic, Inc.
• Dax Sirucek, DC, DACNB
• Maria Teresa Gomez Sirucek, D.C.
• Sisc Anesthesia Inc
• Amanda Sissom
• Brandon Skanderup
• Amanda Kay Skarban
• Amanda Skeen, D.C.
• Kathryn Elizabeth Hallberg Skibba, MD
• Allyson Skidmore

• Obstetrics & Gynecology Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.