Individual provider Active NPI

Michael P Sicilia, MD

  • Emergency Medicine Physician
  • Spokane, WA
National Provider Identifier
1770620551
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00036125 Issued in WA
Practice address
5633 N. Lidergerwood
Spokane, WA 99208
Phone
(509) 482-0111
NPI assigned
Jan 31, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00036125 WA Primary

Addresses

Primary practice location

5633 N. Lidergerwood
Spokane, WA 99208

Mailing address

910 N Washington St
Suite 209
Spokane, WA 99201-2202

Other identifiers 4

IdentifierTypeStateIssuer
MD00036125OtherWALICENCE
8228363MedicaidWA
GAB067779OtherWAMDC PIN #
9611674MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20081231000205 WA Practitioner - Emergency Medicine 8123180080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Services P S Holy Emergency CenterGroup PAC ID 1052594314, 22 clinicians

Practice addresses (Care Compare)

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 484-2460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.16 of 100Reported as group
Quality
91.17
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036125WAMDEmergency Medicine Physician

Organizations & group practices 1

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 1

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1770620551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N WASHINGTON ST",
            "address_2": "SUITE 209",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N. LIDERGERWOOD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "509-482-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIA",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00036125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "MD00036125",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8228363",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDC PIN #",
            "identifier": "GAB067779",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9611674",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.