Individual provider Active NPI

Todd A Sidel, M.D.

  • Anesthesiology Physician
  • Leo, IN
National Provider Identifier
1467435305
Registry record updated Jul 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01056588 Issued in IN
Practice address
4728 Vandolah Rd
Leo, IN 46765-9776
Phone
(260) 241-4501
Fax
(260) 637-7873
NPI assigned
Nov 23, 2005
Last updated
Jul 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01056588 IN Primary

Addresses

Primary practice location

4728 Vandolah Rd
Leo, IN 46765-9776

Mailing address

4728 Vandolah Rd
Leo, IN 46765-9776
Phone (260) 241-4501

Other identifiers 1

IdentifierTypeStateIssuer
200438980MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040823001505 IN Practitioner - Anesthesiology 5597739227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Clinical Colleagues IncGroup PAC ID 8729011333, 170 clinicians
Racc Medical Associates LLCGroup PAC ID 0648424127, 20 clinicians

Practice addresses (Care Compare)

1260 E State Rd
Suite 205
Columbia City, IN 46725-9492
Phone (260) 248-9301

1721 Magnavox Way
Fort Wayne, IN 46804-1537
Phone (260) 748-3650

207 N Townline Rd
Lagrange, IN 46761-1325
Phone (260) 463-9000

401 N Sawyer Rd
Kendallville, IN 46755-2568
Phone (260) 347-8140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056588INMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Racc Medical Associates LLC CurrentSince Sep 1, 2025 Accepting new patients
Racc Medical Associates LLC CurrentSince Sep 1, 2025 Accepting new patients
Clinical Colleagues LLC Anesthesiology CurrentSince May 1, 2023 Accepting new patients

Locations

1314 E 7th St
Ste 201
Auburn, IN 46706
Phone (260) 927-0400

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753574400000",
    "number": "1467435305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4728 VANDOLAH RD",
            "city": "LEO",
            "state": "IN",
            "postal_code": "467659776",
            "telephone_number": "260-241-4501",
            "fax_number": "260-637-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4728 VANDOLAH RD",
            "city": "LEO",
            "state": "IN",
            "postal_code": "467659776",
            "telephone_number": "260-241-4501",
            "fax_number": "260-637-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEL",
        "first_name": "TODD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2025-07-27",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01056588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200438980",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leo, IN

Sources for this page

Verify at the official NPI Registry.