Individual provider Active NPI

Saniya Siddique, M.D.

  • Cardiovascular Disease Physician
  • Erie, PA
National Provider Identifier
1053809988
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD483817 Issued in PA
Practice address
2315 Myrtle St Ste 190
Erie, PA 16502-4604
Phone
(814) 453-7767
Fax
(814) 454-6667
NPI assigned
Apr 26, 2018
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X MD483817 PA Primary

Addresses

Primary practice location

2315 Myrtle St Ste 190
Erie, PA 16502-4604

Mailing address

2315 Myrtle St Ste 190
Erie, PA 16502-4604
Phone (814) 453-7767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20240706000126 PA Practitioner - Cardiovascular Disease (Cardiology) 1850835471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Vincent Consultants in Cardiovascular DiseasesGroup PAC ID 7214124221, 27 clinicians

Practice addresses (Care Compare)

2315 Myrtle St
Suite 190
Erie, PA 16502-4604
Phone (814) 453-7767

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD483817PAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Consultants in Cardiovascular Diseases Cardiovascular Disease CurrentSince Jul 15, 2024 Accepting new patients
St Vincent Medical Education and Research Institute Inc PastSince Jun 29, 2025 Accepting new patients

Locations

2314 Sassafras St
Ste 2
Erie, PA 16502
Phone (814) 452-5105

2315 Myrtle St
Ste 190
Erie, PA 16502
Phone (814) 453-7767

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

Interoperability endpoints

  • Direct secure messaging: saniya.siddique.p1@direct.mmc.nextgenshare.com
  • Direct secure messaging: ssiddique910065@direct.ahn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1053809988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 190",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024604",
            "telephone_number": "814-453-7767",
            "fax_number": "814-454-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 190",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024604",
            "telephone_number": "814-453-7767",
            "fax_number": "814-454-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "SANIYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD483817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.