Sidra Gill

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

60-P128130-01 Issued in NY

Practice address

4646 Fairport Nine Mile PT Rd
Fairport, NY 14450-1163

Phone

(302) 233-5660

NPI assigned

May 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Choice Medical PCGroup PAC ID 1759636491, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clear Choice Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1285155499
  Medicare reassignment Care Compare group NPD
• Ilm Medical Care PLLC

  • Specialist
  • Brooklyn, NY
  • NPI 1023442035
  Medicare reassignment NPD

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1811737414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E CRESCENT AVE",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 FAIRPORT NINE MILE PT RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501163",
            "telephone_number": "302-233-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "SIDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "60-P128130-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moriah Ann Gerhard, LPN
• Lewis G. Giglia, D.P.M.
• Mary Elizabeth Giglio, PT
• Amber Gilbert, RN
• Cooper Eli Gilbert, DPT
• Elaine Sheila Gilmore, M.D.
• Catherine Marie Giuliano, RN
• Meghan Glanton
• Linda Derleth Glathar, RNC BSN
• Jamila Gonzalez, L.M.T.

• Family Medicine Physician in Fairport, NY
• Providers in Fairport, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.