NPIMap

Individual provider Active NPI

Gregory Thomas Sica, MD

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1891766689
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
170474-1 Issued in NY
Practice address
201 W 17TH St
Apt 9D
New York, NY 10011-5374
Phone
(617) 645-4167
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 170474-1 NY
Diagnostic Radiology Physician 2085R0202X 170474-1 NY Primary
Diagnostic Ultrasound Physician 2085U0001X 170474-1 NY

Addresses

Primary practice location

201 W 17TH St
Apt 9D
New York, NY 10011-5374

Mailing address

201 W 17TH St
Apt 9D
New York, NY 10011-5374
Phone (617) 645-4167

Other identifiers 2

IdentifierTypeStateIssuer
3095657MedicaidMA
02194681MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71361CAMDOrthopaedic Hand Surgery Physician
170474-1NYMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Manhattan Diagnostic Imaging, P.C. Diagnostic Radiology Past Accepting new patients
Boston University Medical Center Radiologists, Inc. Body Imaging Past Accepting new patients
Maxwell Medical Imaging, PC Body Imaging Past Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
SLR Diagnostic Radiology, P.C. Body Imaging Past Accepting new patients
East Manhattan Diagnostic Imaging, PC Diagnostic Radiology Past Accepting new patients
Beth Israel Medical Center Diagnostic Radiology Past Accepting new patients
West Side Radiology Associates, PC Diagnostic Radiology Past Accepting new patients
Beth Israel Medical Center Past Accepting new patients
Healthcare Radiology and Diagnostic Systems PLLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1891766689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 17TH ST",
            "address_2": "APT 9D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115374",
            "telephone_number": "617-645-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W 17TH ST",
            "address_2": "APT 9D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115374",
            "telephone_number": "617-645-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICA",
        "first_name": "GREGORY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "170474-1",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "170474-1",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NY",
            "license": "170474-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095657",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02194681",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.