Individual provider Active NPI

Noor Maqsood Siddiqui, M.D.

  • Family Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1104098540
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0072433 Issued in MD
Practice address
324 E Antietam St
Suite 305
Hagerstown, MD 21740-5754
Phone
(301) 791-2510
Fax
(301) 739-7798
NPI assigned
Mar 26, 2008
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0072433 MD Primary

Addresses

Primary practice location

324 E Antietam St
Suite 305
Hagerstown, MD 21740-5754

Mailing address

324 E Antietam St
Suite 305
Hagerstown, MD 21740-5754
Phone (301) 791-2510

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20111209000599 MD Practitioner - Family Practice 8729253349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians
Allegeny Medical LLCGroup PAC ID 2860631959, 2 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

324 E Antietam St
Suite 200
Hagerstown, MD 21740-5792
Phone (301) 791-2510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
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
D0072433MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegeny Medical LLC Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients

Locations

324 E Antietam St
Ste 200
Hagerstown, MD 21740
Phone (301) 791-2510

324 E Antietam St
Ste 305
Hagerstown, MD 21740
Phone (301) 791-2510

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1104098540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 305",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-791-2510",
            "fax_number": "301-739-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 305",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-791-2510",
            "fax_number": "301-739-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "NOOR",
        "middle_name": "MAQSOOD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0072433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.