Kanwaldeep S Sidhu, MD

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

KS054699 Issued in MI

Practice address

23829 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-1186

Phone

(586) 773-1300

Fax

(586) 773-1600

NPI assigned

Apr 4, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Orthopedic Surgery

Education

Wayne State University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians

St. Clair Orthopaedics and Sports Medicine PCGroup PAC ID 4486625027, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Compassus Home Health Home health agency, Warren, MI, CCN 237081
• Henry Ford Home Health Care Home health agency, Detroit, MI, CCN 237087
• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksidhu@stclairortho.gwaydirect.com
• Direct secure messaging: ksidhu63370@direct.hfhs.org

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.

• St Clair Orthopaedics and Sports Medicine PC

  • Orthopaedic Surgery Physician
  • Saint Clair Shores, MI
  • NPI 1720041288
  Medicare reassignment Care Compare group NPD
• St. Clair Orthopaedics and Sports Medicine PC

  • Orthopaedic Surgery Physician
  • Saint Clair Shores, MI
  • NPI 1528587854
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health System

  • Home Health Agency
  • Detroit, MI
  • NPI 1932162096
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation
• Reverence Home Health & Hospice, LLC

  • Home Health Agency
  • Warren, MI
  • NPI 1295772184
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1770545956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801186",
            "telephone_number": "586-773-1300",
            "fax_number": "586-773-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801186",
            "telephone_number": "586-773-1300",
            "fax_number": "586-773-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "KANWALDEEP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MI",
            "license": "KS054699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3164740",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C4763",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0826968",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery of the Spine Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Orthopaedic Surgery of the Spine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.