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Active NPI 1104298090 Individual Practitioner Male Practitioner

Ryan Sidebottom , FNP

Nurse Practitioner - Family • Phoenix, AZ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Ryan Sidebottom, FNP is a certified Nurse Practitioner - Family practicing in Phoenix, AZ. With approximately 11 years of clinical experience since completing medical education in 2015, Ryan Sidebottom delivers high-quality medical care to the local community at 1919 E THOMAS RD.

Ryan Sidebottom is affiliated with Phoenix Children'S Hospital and accepts Medicare assignment.

Frequently performed procedures and clinical services include residence visit for established patient with moderate level of medical decision making, per day, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1919 E Thomas Rd

Phoenix, AZ 850167710

Telephone 6029330985
Fax 6029332442
Associated Practice Facility / Clinic
🏢 Phoenix Children's Hospital Facility NPI 1760480503

Medicare Profile & Education

Medical School

Other

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Family in Phoenix, AZ

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
11 Yrs +2.6 yrs vs City Avg
City Avg: 8.4 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
1264 Specialists

Practicing in Phoenix, AZ (6026 Statewide)

Telehealth Adoption Rate
16.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
47.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sidebottom (11 Years) 11 Yrs
Phoenix Specialty Average (8.4 Years) 8.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes
34 19 $204.41 $107.90

Medical Specialties & State Licenses

Nurse Practitioner - Family Primary Specialty

NUCC Taxonomy Code: 363LF0000X

State License AZ AP8251

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
075841 (AZ)

Hospital & Practice Group Affiliations

Phoenix Children's Hospital

1919 E Thomas Rd, Phoenix, AZ 850167710

Phone: 6029330930

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

22 Associated Practitioners
Dr. Christine Rukasin , MD

Pediatrics - Pediatric Allergy/Immunology

NPI 1043570864

Doctor of Medicine (M.D.)

Dr. Andres Herrera Camino , MD

Pediatrics - Pediatric Pulmonology

NPI 1144587437

Doctor of Medicine (M.D.)

Dr. Richard Wong , DO

Pediatrics - Pediatric Pulmonology

NPI 1174020200

Doctor of Osteopathic Medicine (D.O.)

Chaitali Bose , RD

Dietitian, Registered

NPI 1184274771

Registered Dietitian

Amy Lavery , RD

Dietitian, Registered

NPI 1194304030

Registered Dietitian

Rikki Gross , RD, CSP

Dietitian, Registered

NPI 1205391380

Registered Dietitian, CSP

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location March 27, 2018

Registered at 1919 E THOMAS RD, PHOENIX, AZ 850167710 (Tel: 6029330985)

NPI Profile Active January 30, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 30, 2018

Registered at 4001 E BASELINE RD, STE 206, GILBERT, AZ 852342726 (Tel: 4808922260)

📍
Updated Business Mailing Address January 30, 2018

Registered at 3200 E CAMELBACK RD STE 250, PHOENIX, AZ 850182327 (Tel: 6029331814)

👤
Provider Name / Credentials Updated January 30, 2018

Recorded as RYAN SIDEBOTTOM, FNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2018

Nurse Practitioner (License #AP8251 in AZ)

📍
Updated Business Mailing Address November 09, 2017

Registered at 3200 E CAMELBACK RD STE 250, PHOENIX, AZ 850182327 (Tel: 6029331814)

NPI Profile Active September 19, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 19, 2016

Registered at 4001 E BASELINE RD, STE 206, GILBERT, AZ 852342726 (Tel: 4808922260)

📍
Updated Business Mailing Address September 19, 2016

Registered at 563 W REEVES AVE, SAN TAN VALLEY, AZ 851406717 (Tel: 3073890395)

👤
Provider Name / Credentials Updated September 19, 2016

Recorded as RYAN SIDEBOTTOM, FNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 19, 2016

Nurse Practitioner (License #AP8251 in AZ)

🟢
Initial NPI Registration & Enumeration October 30, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104298090
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 30, 2015
Last Update: March 27, 2018
Sole Proprietor: No

Mailing Address

3200 E Camelback Rd Ste 250

Phoenix, AZ 850182327

Phone: 6029331814

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.