Individual provider Active NPI

Mark Sides, MD

  • Medical Oncology Physician
  • New Orleans, LA
National Provider Identifier
1861879348
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
000000 Issued in LA
Practice address
150 S Robertson St
New Orleans, LA 70112
Phone
(504) 988-5482
NPI assigned
May 4, 2015
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10052624 TX
Medical Oncology Physician 207RX0202X 000000 LA Primary

Addresses

Primary practice location

150 S Robertson St
New Orleans, LA 70112

Mailing address

150 S Robertson St
New Orleans, LA 70112
Phone (504) 988-5482

Other practice location 1

301 University Blvd
Galveston, TX 77555-0570
Phone (409) 772-7063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20200806000345 LA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 9537584685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology
Education
Tulane University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 S Liberty St
New Orleans, LA 70112-2618
Phone (504) 988-6300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10052624TXMDInternal Medicine Physician
000000LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2020 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2020 Accepting new patients
University Healthcare System, L.C. Past Accepting new patients

Locations

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

150 S Liberty St
New Orleans, LA 70112
Phone (504) 988-6300

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1861879348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S ROBERTSON ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-988-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S ROBERTSON ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-988-5482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775550570",
            "country_code": "US",
            "telephone_number": "409-772-7063",
            "fax_number": "409-747-8579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDES",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10052624",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "LA",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.