Individual provider Active NPI

Jasdeep Singh Sidhu, M.D.

  • Cardiovascular Disease Physician
  • Green Bay, WI
National Provider Identifier
1740485440
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
54079-20 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-8000
NPI assigned
Jun 20, 2007
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 54079-20 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

PO Box 735041
Chicago, IL 60673-5041
Phone (800) 326-2250

Other practice location 1

700 S Park St Ste A
Madison, WI 53715-1830
Phone (608) 260-2900

Other identifiers 2

IdentifierTypeStateIssuer
1740485440MedicaidWI
100015964MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address jsidhu372491@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address jsidhu262949@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110822000374 WI Practitioner - Thoracic SurgeryPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5294905683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiovascular Disease (Cardiology)
Education
Medical College of Wisconsin, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000

700 S Park St
Suite a
Madison, WI 53715-1830
Phone (608) 260-2900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Internal Medicine CurrentSince Jun 16, 2020 Accepting new patients
Baycare Aurora, LLC Cardiovascular Disease CurrentSince Sep 16, 2023 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jun 16, 2020 Accepting new patients
Oak Medical SC Internal Medicine CurrentSince May 1, 2023 Accepting new patients
Stoughton Hospital Association Past Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

700 S Park St
Ste A
Madison, WI 53715
Phone (608) 260-2900

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

8301 Old Sauk Rd
Middleton, WI 53562
Phone (608) 662-8842

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

Interoperability endpoints

  • Direct secure messaging: jsidhu262949@direct.myadvocateaurora.org
  • Direct secure messaging: jsidhu372491@direct-ehr-ssmhc.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1740485440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735041",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735041",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St Ste A",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-260-2900",
            "fax_number": "608-260-2956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "JASDEEP",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "54079-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740485440",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100015964",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsidhu372491@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jsidhu372491@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St Ste A",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsidhu262949@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.