NPIMap

Individual provider Active NPI

Osama A Sidhom, MD

  • Gastroenterology Physician
  • West Corina, CA
National Provider Identifier
1649238148
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A50986 Issued in CA
Practice address
1135 S Sunset Ave Ste 405
West Corina, CA 91790
Phone
(626) 960-2326
Fax
(626) 960-9796
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A50986 CA Primary

Addresses

Primary practice location

1135 S Sunset Ave Ste 405
West Corina, CA 91790

Mailing address

1135 S Sunset Ave Ste 405
West Corina, CA 91790
Phone (626) 960-2326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051007000904 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 7012986961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Citrus Valley Gastroenterology a Medical CorporationGroup PAC ID 4284672163, 7 clinicians

Practice addresses (Care Compare)

500 W San Bernardino Rd
Suite B
Covina, CA 91722-3797
Phone (626) 960-2326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy122
Upper gastrointestinal (GI) endoscopy for acid reflux163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50986CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1649238148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 405",
            "city": "WEST CORINA",
            "state": "CA",
            "postal_code": "91790",
            "telephone_number": "626-960-2326",
            "fax_number": "626-960-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 405",
            "city": "WEST CORINA",
            "state": "CA",
            "postal_code": "91790",
            "telephone_number": "626-960-2326",
            "fax_number": "626-960-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHOM",
        "first_name": "OSAMA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A50986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.