Individual provider Active NPI

Shaz Siddiqi, M.D.

  • Allergy & Immunology Physician
  • Lansdowne, VA
National Provider Identifier
1093750796
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101250699 Issued in VA
Practice address
44160 Scholar PLZ
Suite 390
Lansdowne, VA 20176-3459
Phone
(703) 938-3900
Fax
(703) 726-2579
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 0101250699 VA Primary
Allergy & Immunology Physician 207K00000X D0062974 MD

Addresses

Primary practice location

44160 Scholar PLZ
Suite 390
Lansdowne, VA 20176-3459

Mailing address

44160 Scholar PLZ
Suite 390
Lansdowne, VA 20176-3459
Phone (703) 938-3900

Other identifiers 1

IdentifierTypeStateIssuer
020282ZRGMOtherDCMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051006000600 DC Practitioner - Allergy/Immunology 1951335108 Reassigns benefits to 1 organization
I20210824000013 MD Practitioner - Allergy/Immunology 1951335108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asthma and Allergy Center LLCGroup PAC ID 7719909639, 35 clinicians

Practice addresses (Care Compare)

14995 Shady Grove Rd
Suite 100
Rockville, MD 20850-8733
Phone (301) 869-7820

6021 University Blvd
Suite 265
Ellicott City, MD 21043-8503
Phone (410) 772-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062974MDMDAllergy & Immunology Physician
0101250699VAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asthma & Allergy Center LLC Allergy & Immunology CurrentSince Mar 1, 2021 Accepting new patients
Family ENT Allergy and Asthma Center PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

208 Plumtree Rd
Ste B
Bel Air, MD 21015
Phone (410) 638-1999

6021 University Blvd
Ste 265
Ellicott City, MD 21043
Phone (410) 772-8000

161 Thomas Johnson Dr
Ste 150
Frederick, MD 21702
Phone (301) 662-1244

12850 Middlebrook Rd
Ste 103
Germantown, MD 20874
Phone (301) 972-9433

7501 Greenway Center Dr
Ste 440
Greenbelt, MD 20770
Phone (301) 220-1333

14995 Shady Grove Rd
Ste 100
Rockville, MD 20850
Phone (301) 869-7820

2500 Legacy Dr
Ste 200
Frisco, TX 75034

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1093750796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44160 SCHOLAR PLZ",
            "address_2": "SUITE 390",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763459",
            "telephone_number": "703-938-3900",
            "fax_number": "703-726-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44160 SCHOLAR PLZ",
            "address_2": "SUITE 390",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201763459",
            "telephone_number": "703-938-3900",
            "fax_number": "703-726-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SHAZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101250699",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MD",
            "license": "D0062974",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "020282ZRGM",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

Verify at the official NPI Registry.