Sufyan Ahmed Siddiqui, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME143614 Issued in FL

Practice address

985 State Road 436
Casselberry, FL 32707-5664

Phone

(407) 831-5252

Fax

(407) 831-3765

NPI assigned

Mar 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Family Practice

Education

State University of Ny Upstate Medical University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1083956445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 EDGEWATER WAY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329538347",
            "telephone_number": "716-969-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 STATE ROAD 436",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075664",
            "telephone_number": "407-831-5252",
            "fax_number": "407-831-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SUFYAN",
        "middle_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD500001806",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0098740",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME143614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaara Shaham
• Muhammad Raza Shahid, DDS
• Sharing Hands Inc.
• Rosanne Catherine Shinkle, MN, ARNP
• Steven S Shu, M.D.
• Carmen A Silva-Spitalnik
• Cleyde Sena Silva, PHD. CMHP
• Simha Group, Inc.
• Shatima Simmonds
• Frankdesha Sylvia Simmons

• Family Medicine Physician in Casselberry, FL
• Providers in Casselberry, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.