Individual provider Active NPI

Raman Manohar Sidhar, M.D.

  • Family Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1508063868
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A98293 Issued in CA
Practice address
2210 E Highland Ave
Suite # 200
San Bernardino, CA 92404-4671
Phone
(909) 864-1097
Fax
(909) 425-8242
NPI assigned
Jun 29, 2007
Last updated
Dec 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A98293 CA Primary

Addresses

Primary practice location

2210 E Highland Ave
Suite # 200
San Bernardino, CA 92404-4671

Mailing address

2210 E Highland Ave
Suite # 200
San Bernardino, CA 92404-4671
Phone (909) 864-1097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150611000502 CA Order and Referring Only - Family PracticePractitioner - Family Practice 7517024839

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1508063868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 E HIGHLAND AVE",
            "address_2": "SUITE # 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044671",
            "telephone_number": "909-864-1097",
            "fax_number": "909-425-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 E HIGHLAND AVE",
            "address_2": "SUITE # 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044671",
            "telephone_number": "909-864-1097",
            "fax_number": "909-425-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHAR",
        "first_name": "RAMAN",
        "middle_name": "MANOHAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A98293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.