Saaduddin Mohammed Siddiqui, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01083224A Issued in IN

Practice address

9660 Wicker Ave
Saint John, IN 46373-9487

Phone

(219) 365-1177

Fax

(219) 703-6662

NPI assigned

Jun 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Emergency Medicine

Education

University of Chicago, Pritzker School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cep America LLC

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1285103671
  Medicare reassignment Care Compare group NPD
• Community Care Network Inc

  • Family Medicine Physician
  • St John, IN
  • NPI 1457610487
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • East Chicago, IN
  • NPI 1336805563
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

• St Catherine Hospital Inc

  • General Acute Care Hospital
  • East Chicago, IN
  • NPI 1689776882
  Care Compare affiliation

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689379200000",
    "number": "1063940005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9660 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739487",
            "telephone_number": "219-365-1177",
            "fax_number": "219-703-6662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 MacArthur Blvd",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212959",
            "country_code": "US",
            "telephone_number": "219-836-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SAADUDDIN",
        "middle_name": "MOHAMMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2023-07-15",
        "certification_date": "2023-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125070645",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01083224A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300038001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samara Ruder, NP-C
• Mark S Rybczynski, D.O.
• Sarah Marya Sandoval
• Evelyn Sebastian, COTA/L
• Sencare LLC
• Smile Solutions Inc
• Latrese Smith-Wynn, PT, DPT
• Kyerra Smith, MA, BCBA
• South Shore Smiles LLC
• St George Rehabilitation Services LLC

• Emergency Medicine Physician in Saint John, IN
• Providers in Saint John, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2023; 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.