Peter Sidarous, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E100-91 Issued in AR

Practice address

11521 W Markham St
Little Rock, AR 72211-2701

Phone

(501) 502-2765

Fax

(501) 302-1991

NPI assigned

May 14, 2015

Sex

Male

Sole proprietor

Yes

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

Enrolled in AR

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

Family PracticeAlso: Emergency Medicine, Radiation Oncology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sidarous, LLCGroup PAC ID 2163778085, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Sidarous, LLC

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1326531534
  Medicare reassignment Care Compare group NPD Authorized official
• Arkansas Emergency Staffing Solutions, Inc

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1275774630
  Medicare reassignment NPD
• Ess of Fordyce LLC

  • Emergency Medicine Physician
  • Fordyce, AR
  • NPI 1821547977
  Medicare reassignment NPD
• Hospital Care Consultants of Fordyce LLC

  • Hospitalist Physician
  • Fordyce, AR
  • NPI 1316497464
  Medicare reassignment NPD
• Nes Kentucky Inc

  • Emergency Medicine Physician
  • Nashville, AR
  • NPI 1902348048
  Medicare reassignment NPD
• Emergency Staffing Solutions Region III

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1689967895

  AR

  Medicare reassignment NPD
• Medical Office Force

  • Internal Medicine Physician
  • Athens, GA
  • NPI 1508378613

  AR

  Medicare reassignment NPD

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1881072544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11521 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112701",
            "telephone_number": "501-502-2765",
            "fax_number": "501-302-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112701",
            "telephone_number": "501-502-2765",
            "fax_number": "501-302-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDAROUS",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E100-91",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Sickle, MD
• Bola Sidarous, RPH
• George Sidarous, MD
• Sidarous, LLC
• Nancy Maged Sidarous, DDS
• Roopa S Siddaiah, M.D
• Mohammad Saif-Ur-Rehmam Siddiqui, MD
• Sayyadul M Siddiqui, MD
• Shagufta P Siddiqui, MD
• Zainab Siddiqui, MD

• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.