Manuel Sierra, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

M10460 Issued in ID

Practice address

1740 E 17TH St
Suite a
Idaho Falls, ID 83404-6375

Phone

(208) 346-7500

NPI assigned

Feb 19, 2006

Last updated

May 28, 2009By the provider in NPPES

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

Enrolled in ID

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

Psychiatry

Education

University of Washington School of Medicine, 2002

Medicare assignment

May accept Medicare assignment

Group practices

Mental Health SpecialistsGroup PAC ID 1658665427, 11 clinicians

Center Counseling LLCGroup PAC ID 6709165442, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Center Counseling, LLC

  • Mental Health Counselor
  • Chubbuck, ID
  • NPI 1104374974
  Medicare reassignment Care Compare group NPD
• Mental Health Specialists

  • Clinical Social Worker
  • Chubbuck, ID
  • NPI 1548585458

  Child & Adolescent Psychiatry

  Medicare reassignment Care Compare group NPD
• Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Fremont, CA
  • NPI 1164555660
  NPD (past)
• Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Oakland, CA
  • NPI 1861568909
  NPD (past)

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

{
    "created_epoch": "1140307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1861467375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VALLEYVIEW DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044708",
            "telephone_number": "208-244-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 E 17TH ST",
            "address_2": "SUITE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046375",
            "telephone_number": "208-346-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA",
        "first_name": "MANUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-19",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A85395",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "ID",
            "license": "M10460",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "227980",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Sibbett, CRNA
• Rayse Loyd Knight Sickinger, DPT
• Alexis R Siddoway, NP
• Robert Siddoway, LCSW
• Jonathan Sidlow, MD
• Eric Sievers
• Sunita Sigdel
• Signal Hill Counseling LLC
• Signature Homecare LLC
• Signature Hospice LLC (Onesource Homecare & Hospice)

• Child & Adolescent Psychiatry Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Child & Adolescent Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.