DR. EUGENE JOHN SIDOTI JR. (NPI# 1316958945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316958945 |
| Entity Type | Individual |
| Full Name | DR. EUGENE JOHN SIDOTI JR. |
| Credential | M.D. |
| Practice Address |
2601 E Roosevelt St Phoenix AZ 85008-4973 |
| Mailing Address |
2929 E Thomas Rd Phoenix AZ 85016-8034 |
| Practice Telephone | 6023445011 |
| Practice Fax Number | 6023445596 |
| Mailing Telephone | 6024705000 |
| Mailing Fax Number | 6024705064 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2019-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgery | 175407 | NY | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | 59440 | AZ | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | 175407 | NY | Allopathic & Osteopathic Physicians |
| N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
59440 | AZ | Allopathic & Osteopathic Physicians |
| N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
175407 | NY | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
59440 | AZ | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
175407 | NY | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
59440 | AZ | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
175407 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 688 Post Rd Ste 220, Suite 220, Scarsdale, NY 105835015 | 9144727200 | 9144727527 |
| Street Address |
2601 E ROOSEVELT ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85008-4973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538166152 | Paul Zidel I | Orthopaedic Surgery | 2601 E Roosevelt St, Dept of Surgery, Phoenix, AZ 85008-4973 | 2005-06-29 |
| 1881293165 | Christina Wellman | Registered Nurse | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-10-19 |
| 1639786544 | Lindsey Tow | Nurse Anesthetist, Certified Registered | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-09-24 |
| 1003424102 | Susannamma Lijan | Nurse Practitioner | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-07-15 |
| 1184241705 | Katharine Witham | Anesthesiology | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-06-30 |
| 1417574435 | Vishal Ravella | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Valleywise Health, Phoenix, AZ 85008 | 2020-06-26 |
| 1841814894 | Anthony Howard Arnett | Nurse Anesthetist, Certified Registered | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-06-05 |
| 1053932277 | Bhavesh Shukla | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-28 |
| 1659991016 | Luis Francisco Meza | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-25 |
| 1396365839 | Nicholas Donahue Winter | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
| 1194341131 | Abdulbaril Olandapo Olagunju | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 | 2020-06-24 |
| 1376164632 | Abdul Rahman Raed Mustafa Halawa | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 | 2020-04-28 |
| 1245869460 | Zachary Masuda | Student in an Organized Health Care Education/Training Program | Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 | 2020-04-08 |
| 1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
| 1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
| 1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
| 1316412323 | Southwest Human Developement | Early Intervention Provider Agency | 2850 N 24h Street, Phoenix, AZ 85008 | 2018-10-05 |
| 1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
| 1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
| Find all providers in zip 85008 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144430182 | Jason Lee Mussman | Surgery | 10240 W. Indian School Rd., Suite 115, Phoenix, AZ 85037 | 2007-05-22 |
| 1801832977 | Tamir Mosharrafa | Surgery | 4611 E Shea Blvd Ste 230, Phoenix, AZ 85028 | 2006-06-20 |
| 1598705410 | Robert J Mcgregor | Surgery | 7601 N Central Ave, Unit 23, Phoenix, AZ 85020-4079 | 2006-06-08 |
| 1457303471 | Ali M Mosharrafa | Surgery | 4611 E Shea Blvd, Suite 230, Phoenix, AZ 85028-4254 | 2006-05-17 |
| 1730138561 | Travis C Holcombe | Surgery | 300 W Clarendon Ave Ste 440, Phoenix, AZ 85013-3420 | 2006-05-09 |
| 1104817378 | Barry Fernando | Surgery | 2777 E Camelback Rd Ste 140, #780, Phoenix, AZ 85016-4351 | 2005-11-04 |
| 1275521635 | Marc E Gottlieb | Surgery | 1012 E Willetta Street, Phoenix, AZ 85006 | 2005-10-10 |
| 1457969115 | Regenerative Institute Pllc | Surgery | 9250 N 3rd St Ste 1003, Phoenix, AZ 85020-2402 | 2020-07-20 |
| 1164058954 | Leland H Webb Md Plastic Surgery Plc | Surgery | 300 W Clarendon Ave Ste 440, Phoenix, AZ 85013-3476 | 2020-03-12 |
| 1508421819 | Phoenix Plastic Surgery, Pllc | Surgery | 9250 N 3rd St Ste 1003, Phoenix, AZ 85020-2402 | 2019-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.