Sidney K Harnetiaux Thurston, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085011197 Issued in IL

Practice address

390 Office CT
Fairview Heights, IL 62208-2059

Phone

(618) 233-7666

NPI assigned

Apr 7, 2025

Last updated

Sep 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Distinctive Dermatology LTDGroup PAC ID 1850365842, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sthurston@distinctivederm.emadirect.md

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.

• Distinctive Dermatologyltd

  • Dermatology Physician
  • Swansea, IL
  • NPI 1518028398
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1518751585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 OFFICE CT",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082059",
            "telephone_number": "618-233-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 OFFICE CT",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082059",
            "telephone_number": "618-233-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "SIDNEY",
        "middle_name": "K HARNETIAUX",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenzie Thiel
• Kathleen Thomas
• Sonya Thomas
• Jennifer Thompson, P.T.
• Kristen R Thompson, LPT
• Nicole Tillman
• TMS Neurohealth Illinois PLLC
• Courtney Anne Tobin, M.D.
• Trena Place Townes
• Becky J Trost, RPH

• Physician Assistant in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.