Active NPI
Brian T Sidoti, MD
- Internal Medicine Physician
- Phoenix, AZ
National Provider Identifier
1821081357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 29981
- Practice address
- 9225 N 3Rd St
Ste 304
Phoenix, AZ 85020-2439 - Phone
- (602) 445-0751
- Fax
- (602) 424-8128
- NPI assigned
- Aug 30, 2005
- Last updated
- Aug 21, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 29981 | AZ | Primary |
Addresses
Primary practice location
9225 N 3Rd St
Ste 304
Phoenix, AZ 85020-2439
Mailing address
9225 N 3Rd St
Ste 304
Phoenix, AZ 85020-2439
Phone (602) 445-0751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 704305 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29981 | AZ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250812800000",
"number": "1821081357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9225 N 3RD ST",
"address_2": "STE 304",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850202439",
"telephone_number": "602-445-0751",
"fax_number": "602-424-8128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9225 N 3RD ST",
"address_2": "STE 304",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850202439",
"telephone_number": "602-445-0751",
"fax_number": "602-424-8128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDOTI",
"first_name": "BRIAN",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2009-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "29981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "704305",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.