Faryal Asad Siddiqui, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A172297 Issued in CA

Practice address

7720 Fay Ave
La Jolla, CA 92037-4309

Phone

(858) 454-2700

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Tennessee, HSC, College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Jolla Cosmetic Laser Clinic IncGroup PAC ID 6507048576, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Jolla Cosmetic Laser Clinic Inc

  • Specialist
  • La Jolla, CA
  • NPI 1588966238
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1003342072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 FAY AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374309",
            "telephone_number": "858-454-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 FAY AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374309",
            "telephone_number": "858-454-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Punchbowl St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132402",
            "country_code": "US",
            "telephone_number": "808-538-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "FARYAL",
        "middle_name": "ASAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "HI",
            "license": "MDR###",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A172297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Shumway, M.D.
• Natalie Shunnarah, RN
• Gloria Marsha Shurman, PH.D.
• Elina Mikaella Shustef, D.O
• Jason Keith Sicklick, M.D.
• Jordan Andrew Siegel, MD
• Michael E Siegel, M.D.
• Thais Siewert, PMHNP
• Gary Michael Sigafoos, D.D.S.
• Darren Sigal, MD

• Dermatology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.