Rafik Sidaros, M.D.

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

License

A173156 Issued in CA

Practice address

34 Park St
New Haven, CT 06519-1109

Phone

(203) 974-7169

NPI assigned

Jul 31, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lifestancehealth.rafiksidaros@148377.advancedmd-direct.com

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.

• Rafik Sidaros, M.D. Inc.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1740972108

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1962758698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 FOREST AVE STE 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284815",
            "telephone_number": "408-358-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191109",
            "telephone_number": "203-974-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDAROS",
        "first_name": "RAFIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "A173156",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CT",
            "license": "54819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Marie Sicilia, APRN
• Kristen Hope Sickle, PA
• Jenni Victoria Sickler, MA, LCPC, ATR-BC
• Jason Jonathon Sico, M.D.
• Jeanine Sico, PA-C
• Namrah Siddiq
• Zaid Siddique, DO
• Alexa J. Siddon, M.D.
• Michael Sider
• Davinder Singh Sidhu, MD

• Forensic Psychiatry Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Forensic Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.