Individual provider Active NPI

Sidney Dana Sparks, M.D.

  • Pediatrics Physician
  • Oak Harbor, WA
National Provider Identifier
1598719841
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00033179 Issued in WA
Practice address
275 SE Cabot Dr
Suite B-102
Oak Harbor, WA 98277-3715
Phone
(360) 675-5555
Fax
(360) 675-0275
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00033179 WA Primary

Addresses

Primary practice location

275 SE Cabot Dr
Suite B-102
Oak Harbor, WA 98277-3715

Mailing address

275 SE Cabot Dr
Suite B-102
Oak Harbor, WA 98277-3715
Phone (360) 675-5555

Other identifiers 1

IdentifierTypeStateIssuer
8180952MedicaidWA

Other names 1

  • Sidney Irene Dana Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20141222000941 OR Practitioner - Pediatric Medicine 3678896768 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00033179WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of Whidbey Island, PS Pediatrics Past Accepting new patients
Pediatric Associates of Whidbey Island, PS Pediatrics Past Accepting new patients
McKenzie-Willamette Regional Medical Center Associates LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sspark13@yourcarecommunity.org

Organizations & group practices 4

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1598719841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR",
            "address_2": "SUITE B-102",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773715",
            "telephone_number": "360-675-5555",
            "fax_number": "360-675-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SE CABOT DR",
            "address_2": "SUITE B-102",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773715",
            "telephone_number": "360-675-5555",
            "fax_number": "360-675-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "SIDNEY",
        "middle_name": "DANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00033179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8180952",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIDNEY",
            "last_name": "DANA",
            "middle_name": "IRENE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.