Active NPI
Sidra Manzoor
- Internal Medicine Physician
- Eugene, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD197544
- Practice address
- 4010 Aerial Way
Eugene, OR 97402-9757 - Phone
- (541) 687-6349
- Fax
- (541) 242-8361
- NPI assigned
- Jul 13, 2017
- Last updated
- Jan 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD197544 | OR | Primary |
Addresses
Primary practice location
4010 Aerial Way
Eugene, OR 97402-9757
Mailing address
355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-4000
Other practice location 1
355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-4000
Other practice location 2
1200 Hilyard St Ste 230
Eugene, OR 97401-8122
Phone (458) 205-6041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4010 Aerial Way
Eugene, OR 97402-9757
Phone (613) 272-4978
Hospital & facility affiliations
- Sacred Heart Home Health
- Sacred Heart Medical Center - Riverbend
- Peacehealth Cottage Grove Community Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth Medical Group | Internal Medicine | Current | Accepting new patients |
| Peacehealth Medical Group | Current | Accepting new patients | |
| Peacehealth | Internal Medicine | Past | Accepting new patients |
Locations
1200 Hilyard St
Ste 230
Eugene, OR 97401
Phone (458) 205-6016
4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
Organizations & group practices 3
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.
-
dba Nurse Midwifery Birth Center
- Birthing Clinic/Center
- Springfield, OR
- NPI 1881860856
-
dba St. John Medical Center - PeaceHealth Medical Group
- Multi-Specialty Clinic/Center
- Longview, WA
- NPI 1720056187
Internal Medicine
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Eugene, OR
- NPI 1568236974
-
dba Cottage Grove Community Medical CT
- Critical Access Hospital
- Cottage Grove, OR
- NPI 1902892391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1821510504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 RIDGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602023328",
"telephone_number": "847-316-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 AERIAL WAY",
"city": "EUGENE",
"state": "OR",
"postal_code": "974029757",
"telephone_number": "541-687-6349",
"fax_number": "541-242-8361"
}
],
"practiceLocations": [
{
"address_1": "355 Ridge Ave",
"address_purpose": "LOCATION",
"city": "Evanston",
"state": "IL",
"postal_code": "602023328",
"country_code": "US",
"telephone_number": "847-316-4000",
"fax_number": "847-316-6228",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 Hilyard St Ste 230",
"address_purpose": "LOCATION",
"city": "Eugene",
"state": "OR",
"postal_code": "974018122",
"country_code": "US",
"telephone_number": "458-205-6041",
"fax_number": "458-205-6009",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANZOOR",
"first_name": "SIDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-13",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD197544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.