Individual provider Active NPI

Timothy J Siglock, M.D.

  • Otolaryngology Physician
  • Jefferson Valley, NY
National Provider Identifier
1659376036
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
165043 Issued in NY
Practice address
3680 Hill Blvd
Caremount Medical PC
Jefferson Valley, NY 10535-1500
Phone
(914) 241-1050
Fax
(914) 245-7836
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 165043 NY Primary

Addresses

Primary practice location

3680 Hill Blvd
Caremount Medical PC
Jefferson Valley, NY 10535-1500

Mailing address

110 S Bedford Rd
Caremount Medical PC
Mount Kisco, NY 10549-3446
Phone (914) 241-1050

Other identifiers 1

IdentifierTypeStateIssuer
01052804MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090408000223 NY Practitioner - Otolaryngology 5698847093 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
165043NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince May 1, 2009 Accepting new patients
Optum Medical Care, P.C. CurrentSince May 1, 2009 Accepting new patients
Valley Ear, Nose and Throat Otolaryngology PastSince Feb 27, 2008 Accepting new patients

Locations

3680 Hill Blvd
Jefferson Valley, NY 10535
Phone (914) 245-7700

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: timothy.siglock@direct.hvhc.org

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1659376036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "address_2": "CAREMOUNT MEDICAL PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-241-1050",
            "fax_number": "914-245-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 HILL BLVD",
            "address_2": "CAREMOUNT MEDICAL PC",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351500",
            "telephone_number": "914-241-1050",
            "fax_number": "914-245-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGLOCK",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "165043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01052804",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson Valley, NY

Sources for this page

Verify at the official NPI Registry.