Michael L Sidor, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MA57454 Issued in NJ

Practice address

1288 Route 73 South
Suite 100
Mt Laurel, NJ 08054

Phone

(856) 273-8900

Fax

(856) 802-9772

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2012 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851405880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 ROUTE 73 SOUTH",
            "address_2": "SUITE 100",
            "city": "MT LAUREL",
            "state": "NJ",
            "postal_code": "08054",
            "telephone_number": "856-273-8900",
            "fax_number": "856-802-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 ROUTE 73 SOUTH",
            "address_2": "SUITE 100",
            "city": "MT LAUREL",
            "state": "NJ",
            "postal_code": "08054",
            "telephone_number": "856-273-8900",
            "fax_number": "856-802-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOR",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "MA57454",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD046052-L",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DE",
            "license": "C1-0005426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany L Shivers, M.S., CCC-SLP
• Rachel Lauren Shmuts, D.O.
• Monica Shore, LCSW
• SHP VI Centerton Mount Laurel LLC
• Laura Shull, SLP
• Sheila Ann Silver, LCSW
• Devin Scott Simpkins, PHD, LAC, NCC
• Rebecca Simpson
• Grechell Siy
• SJ Sedan and Limousine Service

• Orthopaedic Surgery Physician in Mt Laurel, NJ
• Providers in Mt Laurel, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.