Individual provider Active NPI

Moises A Sidransky, M.D

  • Anesthesiology Physician
  • Tyler, TX
National Provider Identifier
1639469281
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
Q8352 Issued in TX
Practice address
700 Olympic Plaza Cir
Ste 850
Tyler, TX 75701-1951
Phone
(903) 596-3504
NPI assigned
Apr 17, 2011
Last updated
Sep 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X Q8352 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir
Ste 850
Tyler, TX 75701-1951

Mailing address

3970 Louise CT
Tyler, TX 75709-5440
Phone (214) 604-3149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160713000544 TX Practitioner - Pain ManagementPractitioner - Anesthesiology 4284937970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Emory University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

700 Olympic Plaza Cir
Tyler, TX 75701-1952

700 Olympic Plaza Cir
Suite 850
Tyler, TX 75701-1955
Phone (903) 596-3504

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q8352TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients

Locations

340 Seven Springs Way
Ste 100
Brentwood, TN 37027
Phone (615) 296-3000

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2114 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

1000 E 5th St
Ste 100
Tyler, TX 75701
Phone (903) 590-5000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

700 Olympic Plaza Cir
Ste 850
Tyler, TX 75701
Phone (903) 595-2441

901 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 594-2418

Interoperability endpoints

  • Direct secure messaging: msidransky355145@ahs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1639469281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 LOUISE CT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757095440",
            "telephone_number": "214-604-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "STE 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-596-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDRANSKY",
        "first_name": "MOISES",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-17",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q8352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.