Individual provider Active NPI

Daniel Charles Sidesky, APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Madison, WI
National Provider Identifier
1881373611
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023100362 Issued in WI
Practice address
313 Price PL Ste 208
Madison, WI 53705-3262
Phone
(608) 571-3866
NPI assigned
Jul 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023100362 WI Primary

Addresses

Primary practice location

313 Price PL Ste 208
Madison, WI 53705-3262

Mailing address

313 Price PL Ste 208
Madison, WI 53705-3262
Phone (608) 571-3866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007003279 WI Practitioner - Nurse Practitioner 8325579915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Empower Recovery LLCGroup PAC ID 6305292574, 6 clinicians

Practice addresses (Care Compare)

313 Price PL
Suite 208
Madison, WI 53705-3262
Phone (608) 571-3866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023100362WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Recovery LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

313 Price Pl
Ste 208
Madison, WI 53705
Phone (608) 571-3866

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1881373611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 PRICE PL STE 208",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053262",
            "telephone_number": "608-571-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 PRICE PL STE 208",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053262",
            "telephone_number": "608-571-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDESKY",
        "first_name": "DANIEL",
        "middle_name": "CHARLES",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-18",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "2023100362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.