Elise Antoinette Sideris, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

0101261987 Issued in VA

Practice address

1201 Broad Rock Blvd # 181
Richmond, VA 23224-4915

Phone

(804) 675-5000

Fax

(804) 675-6945

NPI assigned

May 13, 2013

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  Medicare reassignment NPD

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487090833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD, #181",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23224",
            "telephone_number": "804-675-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD # 181",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232244915",
            "telephone_number": "804-675-5000",
            "fax_number": "804-675-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDERIS",
        "first_name": "ELISE",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101261987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haya Waseem Siddiqi, MD
• Ahsan B Siddiqui, MD
• Mohammad Bilal Siddiqui, D.O.
• Osman Muddassir Siddiqui, MD
• Christine Siddons
• Kanwar Ajit Singh Sidhu, M.D.
• Claire F Siegel Gerhard, DDS
• Pamela Parker Siegel, LPC
• Linda M Sierra Carey, CRC CRP
• Abigail Elizabeth Sierra

• Geriatric Medicine (Internal Medicine) Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.