Robert Glen Sickinger, D.O.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

34.004355 Issued in OH

Practice address

113 W National Rd
Vandalia, OH 45377-1934

Phone

(937) 223-6837

Fax

(937) 223-3024

NPI assigned

Jul 3, 2006

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

63.67

Promoting interoperability

100

Improvement activities

40

Cost

74.14

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1740210277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 MIAMISBURG CENTERVILLE RD STE 304",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593823",
            "telephone_number": "937-223-6837",
            "fax_number": "937-223-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W NATIONAL RD",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771934",
            "telephone_number": "937-223-6837",
            "fax_number": "937-223-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICKINGER",
        "first_name": "ROBERT",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "34.004355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0827994",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsickinger197653@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1989 Miamisburg Centerville Rd Ste 304",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454593823",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1989 Miamisburg Centerville Rd Ste 304",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454593823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lindsey Marie Sicotte
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• Wendy S Siervogel, RN
• Lisa Aminda Skelton, LMT
• Casey Smedley

• Pulmonary Disease Physician in Vandalia, OH
• Providers in Vandalia, OH by specialty
• Pulmonary Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.