NPIMap

Individual provider Active NPI

David Conrad Siebert, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1780647057
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME88389 Issued in FL
Practice address
1200 Riverplace Blvd
620
Jacksonville, FL 32207-9046
Phone
(904) 396-6620
Fax
(904) 396-6528
NPI assigned
Apr 8, 2006
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME88389 FL Primary

Addresses

Primary practice location

1200 Riverplace Blvd
620
Jacksonville, FL 32207-9046

Mailing address

1200 Riverplace Blvd
620
Jacksonville, FL 32207-9046
Phone (904) 396-6620

Other identifiers 1

IdentifierTypeStateIssuer
269161200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627000953 WA Practitioner - Internal Medicine 3678561966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

17700 SE 272ND St
Covington, WA 98042-4951
Phone (253) 372-6500

202 N Division St
Auburn, WA 98001-4939
Phone (253) 833-7711

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-1000

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Apr 13, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Apr 13, 2022 Accepting new patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Apr 13, 2022 Accepting new patients
First City Hospitalists Group PLLC PastSince Sep 1, 2017 Accepting new patients
Multicare Health System Past Accepting new patients
First Coast Primary Care Inc Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Organizations & group practices 6

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 4

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1780647057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBERT",
        "first_name": "DAVID",
        "middle_name": "CONRAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269161200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.