Marc L Siditsky, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

000373-01 Issued in NY

Practice address

1445 Portland Avenue
Ste 309
Rochester, NY 14621-3008

Phone

(585) 342-2638

Fax

(585) 730-7500

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Physician Assistant

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.

• FLH Medical, PC

  • Family Medicine Physician
  • Penn Yan, NY
  • NPI 1215174644
  Medicare reassignment NPD
• Soldiers & Sailors Memorial Hospital

  dba Soldiers & Sailors Memorial Hospital Hospitalist

  • Emergency Medicine Physician
  • Penn Yan, NY
  • NPI 1043353618
  Medicare reassignment NPD
• Boev Medical, PLLC

  • Neurological Surgery Physician
  • Rochester, NY
  • NPI 1881052546
  Medicare reassignment
• Boev Medical, PLLC

  dba Boev Clinic

  • Neurological Surgery Physician
  • Canandaigua, NY
  • NPI 1922503473

  Physician Assistant

  NPD
• Soldiers & Sailors Memorial Hospital

  • Family Medicine Physician
  • Waterloo, NY
  • NPI 1972101491
  NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1972521847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 PORTLAND AVENUE",
            "address_2": "STE 309",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213008",
            "telephone_number": "585-342-2638",
            "fax_number": "585-730-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 PORTLAND AVENUE",
            "address_2": "STE 309",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213008",
            "telephone_number": "585-342-2638",
            "fax_number": "585-730-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDITSKY",
        "first_name": "MARC",
        "middle_name": "L",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "000373",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "000373-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01272146",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarmad Mohammed Siddiqui, MD
• Candice Irene Sides
• Kamaljit K Sidhu, MD
• Ravinder Sidhu, M.D.
• Katherine Allen Sidi, M.A., CCC-SLP
• Sidney Hillman Health Center of Rochester (Sidney Hillman Health Center Pharmacy)
• Sidney Hillman Health Center of Rochester (Sidney Hillman Health Center Health Services)
• Sidney Hillman Health CNTR of Rochester (Sidney Hillman Health Cntr Optical)
• Wendy Sidorenko
• Stacy Sidoti

• Physician Assistant in Rochester, NY
• Providers in Rochester, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.