Efaza Umar Siddiqui, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

76539 Issued in CT

Practice address

55 Lake Ave N
Worcester, MA 01655

Phone

(508) 334-1000

NPI assigned

Jul 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Diagnostic Radiology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson Radiology PCGroup PAC ID 8729982525, 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Hospital Hospital, Hartford, CT, CCN 070025
• Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008
• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-jefferson

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.

• Jefferson Radiology, PC

  • Diagnostic Radiology Physician
  • Hartford, CT
  • NPI 1396795951
  Medicare reassignment Care Compare group NPD
• Connecticut Imaging Partners, LLC

  • Diagnostic Radiology Physician
  • Wethersfield, CT
  • NPI 1740315761
  Medicare reassignment NPD
• Farmington Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Farmington, CT
  • NPI 1275987802
  Medicare reassignment NPD
• Tic, LLC

  • Diagnostic Radiology Physician
  • Tolland, CT
  • NPI 1457702813
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • Psychiatric Hospital Unit
  • Stafford Springs, CT
  • NPI 1053480293
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1932123569
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1972728442
  Care Compare affiliation
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1104302876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01655",
            "telephone_number": "508-334-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084728",
            "country_code": "US",
            "telephone_number": "401-456-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "EFAZA",
        "middle_name": "UMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "76539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfida E Siceron-Reyna
• Christine Sicuso
• Joseph N. Sidari, MD
• Ghada Siddik
• Asma Siddiqui
• William Sidelinger, MD
• Nancy H Sidhom, NP
• Samarth Singh Sidhu, MD
• Anne Siegel, MS
• Judith Ann Siegel, MD

• Diagnostic Radiology Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.