Individual provider Active NPI

Richard M Dsida, M.D

  • Pediatric Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1457387334
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
036073715 Issued in IL
Practice address
225 East Chicago Ave
Department of Anesthesia
Chicago, IL 60611
Phone
(312) 227-5170
Fax
(312) 227-9730
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 036073715 IL Primary

Addresses

Primary practice location

225 East Chicago Ave
Department of Anesthesia
Chicago, IL 60611

Mailing address

225 East Chicago Ave
Box 19
Chicago, IL 60611-2991
Phone (312) 227-5170

Other practice location 1

2300 Childrens Place
Chicago, IL 60614
Phone (773) 880-4415

Other identifiers 1

IdentifierTypeStateIssuer
036073715MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group PastSince Dec 9, 2019 Accepting new patients

Organizations & group practices 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1457387334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE",
            "address_2": "BOX 19",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-5170",
            "fax_number": "312-227-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-5170",
            "fax_number": "312-227-9730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 CHILDRENS PLACE",
            "address_purpose": "LOCATION",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "country_code": "US",
            "telephone_number": "773-880-4415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DSIDA",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "IL",
            "license": "036073715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073715",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.