Michael James Sivak III, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP049466 Issued in AZ

Practice address

16100 E Palisades Blvd
Fountain Hills, AZ 85268

Phone

(480) 664-5500

NPI assigned

Sep 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1861948432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 W COLUMBINE DRIVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "954-649-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 E PALISADES BLVD",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "85268",
            "telephone_number": "480-664-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAK",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP049466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yelena E Shepard, CCC-SLP
• Parminder Singh Sidhu, M.D
• Genna Michelle Siegelman
• Judith Anne Sievers, LMT NMT
• Kaitlyn Silvernail
• Stephanie S Skiba, ED.S., NCSP
• Nancy Beth Sklar, OTR/L
• SL Fountain View Village LLC
• Victoria Slemmer
• Chastity Small, MS

• All providers in Fountain Hills, AZ
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.