Gregory Scott Sidell, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD61058340 Issued in WA

Practice address

4301 S Pine St Ste 301
Tacoma, WA 98409-7206

Phone

(253) 476-6500

Fax

(253) 476-6547

NPI assigned

Jul 19, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, WA2 enrollments

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 2

Specialty

Psychiatry

Education

Indiana University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Seattle Neuropsychiatric Treatment Center PLLCGroup PAC ID 9335215995, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: greg.sidell.1@32851.direct.athenahealth.com

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.

• Seattle Neuropsychiatric Treatment Center, PLLC

  • Psychiatry Physician
  • Seattle, WA
  • NPI 1609036490
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Greg Sidell MD PLLC

  • Psychiatry Physician
  • Tacoma, WA
  • NPI 1659047298
  NPD (past) Authorized official
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD
• Indiana University Health Bloomington Inc

  • Psychiatry Physician
  • Bloomington, IN
  • NPI 1871519074
  NPD
• Indiana University Health Bloomington Inc

  • Community/Retail Pharmacy
  • Bloomington, IN
  • NPI 1922640077
  NPD
• Mary K. Simonson, MD PLLC

  • Medical Specialty Clinic/Center
  • Tacoma, WA
  • NPI 1295334555
  NPD (past)
• Inner Healing Charleston LLC

  • Psychiatry Physician
  • Charleston, SC
  • NPI 1851117014
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1780603530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 301",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097206",
            "telephone_number": "253-476-6500",
            "fax_number": "253-476-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 301",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097206",
            "telephone_number": "253-476-6500",
            "fax_number": "253-476-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDELL",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61058340",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01052695A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200303280A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4301 S Pine St Ste 301",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984097206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Noal R Shurak, PSYD
• Robert Sibley, DO
• Suzanne Sica, PA-C
• Nicholas Sich, M.D.
• Laila F Siddiqui, MD
• Damanjot Kaur Sidhu, PA-C
• Aboubacar Sidibe, LPN
• Sidney F Whaley Jr
• Heather Lee Siegel, ARNP
• Karen Michele Siegel, PH.D.

• Psychiatry Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.
• 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.