Jonathan Sidle

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP1028619 Issued in TX

Practice address

9410 Dugas Dr
San Antonio, TX 78245-1869

Phone

(210) 756-6235

NPI assigned

Sep 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Medical Vein Clinic

  • Diagnostic Radiology Physician
  • San Antonio, TX
  • NPI 1538696471
  Medicare reassignment NPD

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1750996534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9410 DUGAS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782451869",
            "telephone_number": "210-756-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9410 DUGAS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782451869",
            "telephone_number": "210-756-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDLE",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "792196",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP1028619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saqib A Siddiqui, MD
• Umar Siddiqui, DO
• Matthew Jay Sideman, MD
• Prajna Sidhu, M.D.
• Mojda Sidiqi, MD
• Anissa Sidney
• Eddy Sidra, O.D.
• Sidyan PLLC (Dominion Neurology Associates)
• Amber C Siebenthall, SLPA
• Amalia Jean Siebert, PTA

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.