Gary Otto Siemons, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

25MA04074600 Issued in NJ

Practice address

502 Centennial Blvd
Suite 5
Voorhees, NJ 08043

Phone

(856) 429-8030

Fax

(856) 428-2718

NPI assigned

Aug 9, 2005

Last updated

Jul 25, 2018By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Surgical Specialists of New Jersey, LLC

  • Surgery Physician
  • Marlton, NJ
  • NPI 1851345870

  Colon & Rectal Surgery

  NPD (past)
• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  Colon & Rectal Surgery

  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1427059930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-762-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 CENTENNIAL BLVD",
            "address_2": "SUITE 5",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-429-8030",
            "fax_number": "856-428-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMONS",
        "first_name": "GARY",
        "middle_name": "OTTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "25MA04074600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1655507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Shurman, MD
• Tariq S. Siddiqi, M.D.
• Raheel A Siddiqui, MT
• Sarah Sidman, LPC, LCADC
• Alyson Sidoti, OTR/L
• Jennifer Sikorski, PA-C
• Arielle S. Silver, M.D.
• Elisheva Silverman, PA-C
• Sydney Allan Silverman, D.D.S
• Simply Special Dental of Voorhees, LLC

• Colon & Rectal Surgery Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Colon & Rectal Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.