Vickie Suzanne Sidwa, APN, C.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NN10119300 Issued in NJ

Practice address

1043 Montauk Dr
Forked River, NJ 08731-2004

Phone

(609) 339-5667

NPI assigned

Oct 18, 2006

Sex

Female

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

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Harmony Group LLC

  • Psychologist
  • Somerville, NJ
  • NPI 1417372855
  Medicare reassignment NPD
• NJ Certified Dermatology PC

  • Dermatology Physician
  • Neptune, NJ
  • NPI 1003263807
  Medicare reassignment NPD
• NJ Certified Dermatology PC

  dba Dedicated Dermatology

  • Dermatology Physician
  • Allentown, PA
  • NPI 1326496241
  NPD (past)
• Vericare Behavioral Health of New Jersey, P.a.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1669408274
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1912088972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 MONTAUK DR",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087312004",
            "telephone_number": "609-339-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 MONTAUK DR",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087312004",
            "telephone_number": "609-339-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDWA",
        "first_name": "VICKIE",
        "middle_name": "SUZANNE",
        "credential": "APN, C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NN10119300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ying-Chieh Shen, L.AC
• Allizey Shields, OTR
• Shivita RX LLC (Lacey Pharmacy and Convenience)
• Tracey Shrestha, D.M.D.
• Sidwa Enterprise II, LLC
• Erica Simi, OTD, OTR/L
• Donnalee Snyder, LPC, LCADC
• Ryan Richard Sorg, OD
• Jana Soto, L.AC.
• Alyse Renee Spafford, BCBA

• Adult Health Nurse Practitioner in Forked River, NJ
• Providers in Forked River, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.