Individual provider Active NPI

Surinderpal Sidhu, MD

  • Internal Medicine Physician
  • Milford, MA
National Provider Identifier
1528023967
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56299 Issued in MA
Practice address
211 West St
Suite 1
Milford, MA 01757-3905
Phone
(508) 473-2022
Fax
(508) 478-7395
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9134 RI
Internal Medicine Physician 207R00000X 56299 MA Primary

Addresses

Primary practice location

211 West St
Suite 1
Milford, MA 01757-3905

Mailing address

211 West St
Suite 1
Milford, MA 01757-3905
Phone (508) 473-2022

Other identifiers 3

IdentifierTypeStateIssuer
8025262MedicaidRI
0000203829OtherRIBLUE CHIP
0000022375OtherRIBC BS RI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56299MAMDInternal Medicine Physician
9134RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Street Medical Inc Internal Medicine PastSince Jun 17, 2017 Accepting new patients
Sidhu Medical Assoc PC Internal Medicine PastSince Jan 1, 2009 Accepting new patients
Landmark Physician Office Services Internal Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1528023967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 WEST ST",
            "address_2": "SUITE 1",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573905",
            "telephone_number": "508-473-2022",
            "fax_number": "508-478-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 WEST ST",
            "address_2": "SUITE 1",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573905",
            "telephone_number": "508-473-2022",
            "fax_number": "508-478-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "SURINDERPAL",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "9134",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "56299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8025262",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "0000203829",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS RI",
            "identifier": "0000022375",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.