Individual provider Active NPI

Jennifer M Sidman, M.D.

  • Family Medicine Physician
  • Gainesville, FL
National Provider Identifier
1578592473
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME61151 Issued in FL
Practice address
4011 NW 43Rd St
Suite a
Gainesville, FL 32606-4609
Phone
(352) 373-0211
Fax
(352) 373-0214
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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 ME61151 FL Primary

Addresses

Primary practice location

4011 NW 43Rd St
Suite a
Gainesville, FL 32606-4609

Mailing address

4011 NW 43Rd St
Suite a
Gainesville, FL 32606-4609
Phone (352) 373-0211

Other identifiers 1

IdentifierTypeStateIssuer
18706OtherFLBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JENNIFER.SIDMAN@hca5.eclinicaldirectplus.com

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.77 of 100Reported as group
Quality
87.6
Promoting interoperability
99
Improvement activities
40
Cost
72.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Diagnostics Inc Past Accepting new patients
Florida Skin Cancer & Dermatology Specialists, PA PastSince Nov 1, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1578592473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 NW 43RD ST",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326064609",
            "telephone_number": "352-373-0211",
            "fax_number": "352-373-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 NW 43RD ST",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326064609",
            "telephone_number": "352-373-0211",
            "fax_number": "352-373-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDMAN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME61151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18706",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JENNIFER.SIDMAN@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4011 NW 43rd St",
            "address_2": "SUITE A",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326064609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.