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SIDHARTH MOHAN MSD, BDS, BS
NPI 1558830794
Dentist - Prosthodontics in Shorewood, IL

Active since November 16, 2018Opted out of Medicare · through Nov 14, 2027
964 BROOKFOREST AVE, SHOREWOOD, IL 60404(815) 254-1177 Get Directions Write a Review

NPPES record last updated: October 6, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 6, 2019, Nov 28, 2018, Nov 16, 2018 (3 updates tracked since 2018).

About Sidharth Mohan Msd, Bds, Bs NPPES

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

SIDHARTH MOHAN MSD, BDS, BS (NPI 1558830794) is an individual prosthodontics provider in Shorewood, Illinois, licensed in Illinois (019.031930) and active in the NPI registry since November 2018. He has opted out of Medicare through November 14, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1558830794
Entity TypeIndividualMale
Primary Taxonomy1223P0700X
Provider Legal NameSIDHARTH MOHANCredential: MSD, BDS, BS
Location Address964 BROOKFOREST AVEShorewood, IL 60404-8807
Mailing Address964 Brookforest AveShorewood, IL 60404-8807 · (864) 940-8987
Phone(815) 254-1177
Sole ProprietorNo
Enumeration DateNovember 16, 2018
Last NPPES UpdateOctober 6, 20193 updates tracked since enumeration
✔ NPI 1558830794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
License✔ Licensed in IL · 019.031930
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
Also ListedDentistTaxonomy 122300000X · License 019.031930 (IL)
964 BROOKFOREST AVE, Shorewood, IL 60404
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Sidharth Mohan Msd, Bds, Bs has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 14, 2019 through November 14, 2027.

Opt-Out Effective DateNovember 14, 2019
Opt-Out In Effect ThroughNovember 14, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60404 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$74.38 typical visit price
range $19.15 – $147.12
Typical copayment $18.59 (range $4.78 – $36.78)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Sidharth Mohan's NPI number?

The NPI number for Sidharth Mohan is 1558830794. It was assigned to this individual provider in the NPPES registry on November 16, 2018.

Where is Sidharth Mohan located?

Sidharth Mohan practices at 964 Brookforest Ave, Shorewood, IL 60404. The listed phone number is (815) 254-1177.

What is Sidharth Mohan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Is Sidharth Mohan enrolled in Medicare?

No. Sidharth Mohan has opted out of Medicare through November 14, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Sidharth Mohan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Anthem Blue Cross and Blue Shield and BEST Life and 7 other insurers list Sidharth Mohan 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 Sidharth Mohan was last updated on October 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.