Individual provider Active NPI

Amina Siddiqui

  • Speech-Language Pathologist
  • Plymouth, MI
National Provider Identifier
1093484172
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085
Phone
(313) 278-4601
NPI assigned
Sep 10, 2021
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085

Mailing address

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085
Phone (313) 278-4601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923002270 MI Practitioner - Qualified Speech Language Pathologist 2769867928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Special Tree Neuro Care Center CurrentSince Feb 25, 2026 Accepting new patients
Special Tree Neuro Care Center CurrentSince Feb 25, 2026 Accepting new patients

Locations

10909 Hannan Rd
Romulus, MI 48174
Phone (734) 893-1000

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.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1093484172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "313-278-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "313-278-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AMINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.