Nicole Renee Sydow, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Flagstaff, Arizona. She went to Southern Illinois University School Of Medicine and graduated in 2007 and has 17 years of diverse experience with area of expertise as Thoracic Surgery. She is a member of the group practice Phoenix Cardiac Surgery Pc and her current practice location is
1215 N Beaver St, Suite 203, Flagstaff, Arizona. You can reach out to her office (for appointments etc.) via phone at
(928) 773-2150.
Nicole Renee Sydow is licensed to practice in Arizona (license number 46018) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1255598900.
Physician's Profile
| Full Name | Nicole Renee Sydow |
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| Gender | Female |
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| Speciality | Thoracic Surgery |
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| Experience | 17 Years |
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| Location | 1215 N Beaver St, Flagstaff, Arizona |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicole Renee Sydow attended and graduated from Southern Illinois University School Of Medicine in 2007
NPI Data:
- NPI Number: 1255598900
- Provider Enumeration Date: 05/20/2008
- Last Update Date: 02/19/2016
Medicare PECOS Information:
- PECOS PAC ID: 9234357393
- Enrollment ID: I20140902002245
Medical Identifiers
Medical identifiers for Nicole Renee Sydow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255598900 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 57.012994 (Ohio) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 46018 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Phoenix Cardiac Surgery Pc | 8426943036 | 9 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole Renee Sydow allows following entities to bill medicare on her behalf.
| Entity Name | Banner -- University Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508809427
PECOS PAC ID: 7719899871
Enrollment ID: O20031105000694 |
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| Entity Name | Phoenix Cardiac Surgery Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184653958
PECOS PAC ID: 8426943036
Enrollment ID: O20040220000726 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Renee Sydow is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Nicole Renee Sydow, MD
3131 E Clarendon Ave, Suite 102,
Phoenix, AZ 85016-7069
Ph: (602) 253-9168 | Nicole Renee Sydow, MD
1215 N Beaver St, Suite 203,
Flagstaff, AZ 86001-3126
Ph: (928) 773-2150 |
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