Active NPI
Bonnie Jean Sidari, DO
- Family Medicine Physician
- Beachwood, OH
National Provider Identifier
1699883959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34-006458
- Practice address
- 3909 Orange PL Ste 2100
Beachwood, OH 44122-8400 - Phone
- (216) 896-1800
- Fax
- (216) 896-1801
- NPI assigned
- Aug 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34-006458 | OH | Primary |
Addresses
Primary practice location
3909 Orange PL Ste 2100
Beachwood, OH 44122-8400
Mailing address
PO Box 8792
Belfast, ME 04915-8792
Phone (216) 896-1800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34-006458 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Hospital System Inc | Past | Accepting new patients | |
| University Primary Care Practices Inc. | Past | Accepting new patients | |
| J&K Pain Management Company LLC | Past | Accepting new patients | |
| University Primary Care Practices Inc | Past | Accepting new patients | |
| University Hospitals Medical Practices Inc | Past | Accepting new patients | |
| Lake Hospital System Inc. | Past | Accepting new patients | |
| Lake Hospital System | Past | Accepting new patients |
Organizations & group practices 7
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245196800000",
"number": "1699883959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8792",
"city": "BELFAST",
"state": "ME",
"postal_code": "049158792",
"telephone_number": "216-896-1800",
"fax_number": "216-896-1801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3909 ORANGE PL STE 2100",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441228400",
"telephone_number": "216-896-1800",
"fax_number": "216-896-1801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDARI",
"first_name": "BONNIE",
"middle_name": "JEAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-28",
"last_updated": "2009-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34-006458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.