Individual provider Active NPI

Sidney Semrad, D.O.

  • Obstetrics & Gynecology Physician
  • Mesa, AZ
National Provider Identifier
1770525396
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2605 Issued in AZ
Practice address
4566 E Inverness Ave
#202
Mesa, AZ 85206-4634
Phone
(480) 464-2101
Fax
(480) 854-4913
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2605 AZ Primary

Addresses

Primary practice location

4566 E Inverness Ave
#202
Mesa, AZ 85206-4634

Mailing address

7233 E Baseline Rd
Ste 101
Mesa, AZ 85209-5001
Phone (480) 464-2101

Other identifiers 1

IdentifierTypeStateIssuer
410986MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20111213000305 AZ Practitioner - Obstetrics/Gynecology 0840275046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Vista Regional Health Center Medical Group LLCGroup PAC ID 3779732854, 45 clinicians

Practice addresses (Care Compare)

5750 E Hwy 90
Suite 300B
Sierra Vista, AZ 85635-9114
Phone (520) 263-3620

Hospital & facility affiliations

  • Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2605AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Arizona, P.C. Obstetrics & Gynecology CurrentSince Sep 1, 2022 Accepting new patients
Sierra Vista Regional Health Center Medical Group LLC Obstetrics & Gynecology CurrentSince Jul 1, 2017 Accepting new patients
Mesa Obstetricians & Gynecologists, LTD Obstetrics & Gynecology Past Accepting new patients
RCHP-Sierra Vista Inc Past Accepting new patients

Locations

1111 N F Ave
Douglas, AZ 85607
Phone (520) 364-6860

5750 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

5750 E Highway 90
Ste 300A
Sierra Vista, AZ 85635
Phone (520) 458-8075

5750 E Highway 90
Ste 300B
Sierra Vista, AZ 85635
Phone (520) 263-3620

5750 E Highway 90
Ste 200
Sierra Vista, AZ 85635
Phone (520) 263-3500

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

Interoperability endpoints

  • Direct secure messaging: sidney.semrad.1@19231.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1770525396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7233 E BASELINE RD",
            "address_2": "STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095001",
            "telephone_number": "480-464-2101",
            "fax_number": "480-854-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E INVERNESS AVE",
            "address_2": "#202",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064634",
            "telephone_number": "480-464-2101",
            "fax_number": "480-854-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMRAD",
        "first_name": "SIDNEY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "2605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410986",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.