1. Home
  2. Directory
  3. Arizona
  4. Tucson
  5. Dietitian Registered
  6. NPI Profile

KALLIE MARIE SIDEREWICZ RDN
NPI 1073056545
Dietitian, Registered in Tucson, AZ

Active since November 30, 2016
5301 E GRANT RD, TUCSON, AZ 85712(520) 730-1582 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kallie Marie Siderewicz Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KALLIE MARIE SIDEREWICZ RDN (NPI 1073056545) is an individual dietitian, registered in Tucson, Arizona, licensed in Arizona (86009790) and active in the NPI registry since November 2016.

NPPES Registry Identity

NPI1073056545
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameKALLIE MARIE SIDEREWICZCredential: RDN
Location Address5301 E GRANT RDTucson, AZ 85712-2805
Mailing AddressPo Box 31235Tucson, AZ 85751-1235 · (520) 324-4100
Phone(520) 730-1582
Sole ProprietorNo
Enumeration DateNovember 30, 2016
Last NPPES UpdateSeptember 14, 2021
NPPES CertifiedSeptember 14, 2021
✔ NPI 1073056545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in AZ · 86009790
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
5301 E GRANT RD, Tucson, AZ 85712
Open in Google Maps ↗

Other Identifiers 2

Other86009790AZ · Rdn Certificate
Medicaid220882AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kallie Marie Siderewicz Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kallie Siderewicz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tmc Medical Network
Same address
Multi-Specialty
5301 E GRANT RD
Tucson, AZ 85712
  • Reassigned Medicare billing, Arizona enrollment
  • 471 clinicians in this Medicare group
NPI 1750832283 (520) 327-5461

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY JEANNE GRAHAM M.D.
Anesthesiology
5301 E GRANT RD, THMEP
TUCSON, AZ 85712
Pima County (520) 324-5095
SAMANTHA PENN PHARMD
Pharmacist
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 324-5122
DR. VICTOR HUGO RUIZ PHARMD
Student in an Organized Health Care Education/Training Program
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 324-2516
SARA PETTEY SANDIFER MD
Student in an Organized Health Care Education/Training Program
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 324-5095
JOSHUA LEE M.D.
Internal Medicine
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 324-5524
VANESSA LYNN PORTOR RN
Registered Nurse (Lactation Consultant)
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 324-5730
MRS. KRISTY BELONE FNP-C
Nurse Practitioner (Family)
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 324-5461
LORRAINE Y YENTZER AGACNP
Nurse Practitioner (Gerontology)
5301 E GRANT RD
TUCSON, AZ 85712
Pima County (520) 327-5461

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kallie Siderewicz's NPI number?

The NPI number for Kallie Siderewicz is 1073056545. It was assigned to this individual provider in the NPPES registry on November 30, 2016.

Where is Kallie Siderewicz located?

Kallie Siderewicz practices at 5301 E Grant Rd, Tucson, AZ 85712. The listed phone number is (520) 730-1582.

What is Kallie Siderewicz's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Kallie Siderewicz enrolled in Medicare?

Yes. Kallie Siderewicz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kallie Siderewicz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kallie Siderewicz reassigns Medicare benefits to Tmc Medical Network (Tucson, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kallie Siderewicz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kallie Siderewicz accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc list Kallie Siderewicz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kallie Siderewicz was last updated on September 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.