Individual provider Active NPI

Saad Siddiqui, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1013421569
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110932 Issued in FL
Practice address
1800 Mercy Dr
Orlando, FL 32808-5646
Phone
(407) 875-3700
Fax
(407) 667-1636
NPI assigned
Nov 20, 2017
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110932 FL Primary

Addresses

Primary practice location

1800 Mercy Dr
Orlando, FL 32808-5646

Mailing address

1145 Woods Landing Dr
Minneola, FL 34715-6067
Phone (321) 682-9200

Other practice location 1

2033 Gateway Pl Fl 5
San Jose, CA 95110-3709
Phone (657) 500-0634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestream Behavioral Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: saad.siddiqui.2@18731.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1013421569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 WOODS LANDING DR",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347156067",
            "telephone_number": "321-682-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MERCY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085646",
            "telephone_number": "407-875-3700",
            "fax_number": "407-667-1636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2033 Gateway Pl Fl 5",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951103709",
            "country_code": "US",
            "telephone_number": "657-500-0634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SAAD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-20",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.