NPIMap

Individual provider Active NPI

Abdul R Siddiqui, MD

  • Infectious Disease Physician
  • Auburn, WA
National Provider Identifier
1073552709
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD60266117 Issued in WA
Practice address
202 N Division St Ste 301
Auburn, WA 98001-4939
Phone
(253) 288-3040
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 35-069270 OH
Infectious Disease Physician 207RI0200X MD60266117 WA Primary

Addresses

Primary practice location

202 N Division St Ste 301
Auburn, WA 98001-4939

Mailing address

202 N Division St Ste 301
Auburn, WA 98001-4939
Phone (253) 288-3040

Other identifiers 1

IdentifierTypeStateIssuer
2673067MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120501000308 WA Practitioner - Infectious DiseasePractitioner - Internal Medicine 8325055783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 140
Bellevue, WA 98004-4633
Phone (425) 455-8248

Hospital & facility affiliations

  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-069270OHMDInfectious Disease Physician
MD60266117WAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jan 28, 2019 Accepting new patients
Premier Health Specialists Inc Past Accepting new patients
Hospitalists of Pueblo Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

1135 116th Ave NE
Ste 140
Bellevue, WA 98004
Phone (425) 455-8248

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

Organizations & group practices 5

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.

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1073552709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST STE 301",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-288-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST STE 301",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-288-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ABDUL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35-069270",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD60266117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2673067",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.