Individual provider Active NPI

John E Sidle, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1780632174
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01046577A Issued in IN
Practice address
1112 Southeastern Ave
Indianapolis, IN 46202-3947
Phone
(317) 880-1900
Fax
(317) 880-1935
NPI assigned
May 5, 2006
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01046577A IN Primary
Pediatrics Physician 208000000X 01046577A IN

Addresses

Primary practice location

1112 Southeastern Ave
Indianapolis, IN 46202-3947

Mailing address

PO Box 637764
Cincinnati, OH 45263-7764
Phone (317) 880-3939

Other identifiers 1

IdentifierTypeStateIssuer
200040640MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsidle14401@direct.eskenazihealth.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040611000442 IN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5890778641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

720 Eskeanzi Ave
Indianapolis, IN 46202-5166
Phone (317) 880-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01046577AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eskenazi Medical Group Inc Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients
University Emergency Medicine Past Accepting new patients

Locations

1001 W 10th St
Indianapolis, IN 46202
Phone (317) 630-6175

1434 Shelby St
Indianapolis, IN 46203
Phone (317) 453-3398

1700 N Illinois St
Indianapolis, IN 46202
Phone (317) 554-5700

2700 Martin Luther King Jr St
Indianapolis, IN 46208
Phone (317) 931-4300

2732 W Michigan St
Indianapolis, IN 46222
Phone (317) 554-4600

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

6940 Michigan Rd
Ste 140
Indianapolis, IN 46268
Phone (317) 266-2901

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1780632174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637764",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637764",
            "telephone_number": "317-880-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 SOUTHEASTERN AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023947",
            "telephone_number": "317-880-1900",
            "fax_number": "317-880-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDLE",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01046577A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01046577A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200040640",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsidle14401@direct.eskenazihealth.edu",
            "affiliation": "N",
            "address_1": "1112 Southeastern Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462023947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.