NPIMap

Individual provider Active NPI

Sidarth Dasari

  • Neurology Physician
  • Boulder, CO
National Provider Identifier
1497286421
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DR.0068451 Issued in CO
Practice address
2750 Broadway St
Boulder, CO 80304-3586
Phone
(303) 440-3000
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 311231 NY
Neurology Physician 2084N0400X 042-0015282 VT
Neurology Physician 2084N0400X DR.0068451 CO Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3586

Mailing address

2750 Broadway St
Boulder, CO 80304-3586

Other practice location 1

2121 E Harmony Rd Unit 180
Fort Collins, CO 80528-3401
Phone (970) 226-6111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sidarth.dasari.1@32973.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220921001805 CO Practitioner - Neurology 7214208396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

2121 E Harmony Rd
Unit 180
Fort Collins, CO 80528-3401
Phone (970) 226-6111

2964 Ginnala Dr
Loveland, CO 80538-2701
Phone (970) 667-7755

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0068451COMDNeurology Physician
311231NYMDNeurology Physician
042-0015282VTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Neurology of Colorado, LLC Neurology CurrentSince Apr 1, 2024 Accepting new patients
Advanced Neurology of Colorado, LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

2121 E Harmony Rd
Unit 180
Fort Collins, CO 80528
Phone (970) 226-6111

Interoperability endpoints

  • Direct secure messaging: sidarth.dasari.1@32973.direct.athenahealth.com

Organizations & group practices 2

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 54

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

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1497286421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043586",
            "telephone_number": "303-440-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 E Harmony Rd Unit 180",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805283401",
            "country_code": "US",
            "telephone_number": "970-226-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASARI",
        "first_name": "SIDARTH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "311231",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VT",
            "license": "042-0015282",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0068451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sidarth.dasari.1@32973.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2121 E Harmony Rd Unit 180",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805283401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.