RYAN SIDEBOTTOM FNP
NPI 1104298090
Nurse Practitioner - Family in Phoenix, AZ

Q: What is Ryan Sidebottom's NPI number?

The NPI number for Ryan Sidebottom is 1104298090. It was assigned to this individual provider in the NPPES registry on October 30, 2015.

Q: What is Ryan Sidebottom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Ryan Sidebottom was last updated on March 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since October 30, 2015PECOS EnrolledAccepts Medicare Assignment

1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-0985(602) 933-2442 Get Directions Write a Review

NPPES record last updated: March 27, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 27, 2018, Mar 17, 2018, Nov 9, 2017 and 2 more (5 updates tracked since 2015).

On this page

About Ryan Sidebottom Fnp NPPES

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

RYAN SIDEBOTTOM FNP (NPI 1104298090) is an individual family provider in Phoenix, Arizona, licensed in Arizona (AP8251) and active in the NPI registry since October 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1104298090

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameRYAN SIDEBOTTOMCredential: FNP

Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710

Mailing Address3200 E Camelback Rd Ste 250Phoenix, AZ 85018-2327 · (602) 933-1814

Phone(602) 933-0985

Fax(602) 933-2442

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateOctober 30, 2015

Last NPPES UpdateMarch 27, 20185 updates tracked since enumeration

✔ NPI 1104298090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · AP8251

1919 E THOMAS RD, Phoenix, AZ 85016

Open in Google Maps ↗

Other Identifiers 1

Medicaid075841AZ

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ryan Sidebottom Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537457528

PECOS Enrollment IDI20161006000970

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. TIMUR RAGHIB M.D.

Hospitalist