Individual provider Active NPI

Bonnie Jean Sidari, DO

  • Family Medicine Physician
  • Beachwood, OH
National Provider Identifier
1699883959
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-006458 Issued in OH
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

Updated by the provider on Jun 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
34-006458OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.