Maryam Sickinger, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

20A10108 Issued in CA

Practice address

41990 Cook St BLDG F1006
Palm Desert, CA 92211-6100

Phone

(760) 568-9300

Fax

(760) 568-9331

NPI assigned

Mar 17, 2010

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Dermatology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• Advanced Institute of Dermatology, Inc

  • Dermatology Physician
  • Palm Desert, CA
  • NPI 1184919011
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1841514049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41990 COOK ST BLDG F1006",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116100",
            "telephone_number": "760-568-9300",
            "fax_number": "760-568-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41990 COOK ST BLDG F1006",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116100",
            "telephone_number": "760-568-9300",
            "fax_number": "760-568-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICKINGER",
        "first_name": "MARYAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "20A10108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20A10108",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Shiller, ACSW
• Kimberly Shipman, L.AC.
• Karah Rose Shouse, OTR/L
• Ornella Siakam
• Bianchi Siapno, PHARM.D.
• Nicole Sidor, DPT
• Alan W Siegel, O.D.
• Ronni Sigmund, CDACC II
• Michael J. Silver, MFT
• Homayoun Siman, MD

• Dermatology Physician in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.