Philip Alden Sidell, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

31011 Issued in MN

Practice address

3920 Sunnyside Rd
Edina, MN 55424-1211

Phone

(952) 926-3002

Fax

(952) 926-7744

NPI assigned

Jan 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment NPD
• Morningside Family Physicians

  • Clinic/Center
  • Edina, MN
  • NPI 1992027007
  Authorized official Same address or phone
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982759288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 SUNNYSIDE RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241211",
            "telephone_number": "952-926-3002",
            "fax_number": "952-926-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 SUNNYSIDE RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241211",
            "telephone_number": "952-926-3002",
            "fax_number": "952-926-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDELL",
        "first_name": "PHILIP",
        "middle_name": "ALDEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "31011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul J Shlafer, O.D.
• Jamie Sarah Shores, DPT
• Michelle Shorten
• Fatxi Abdi Shukri
• John Charles Shultz, PA-C
• Winifred Sidibe, APRN, CRNA
• Natalie Sidun
• Matthew Siewert
• Mark Bevers Sigmond, M.D.
• Esmeralda Selene Silva, DACM

• General Practice Physician in Edina, MN
• Providers in Edina, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.