Siddharth Balaji, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Atlantis, FL
NPI 1104627249 · NPPES record last updated Mar 24, 2025
Key facts
- NPI
- 1104627249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 5301 S Congress Ave
Atlantis, FL 33462-1149 - Phone
- (561) 313-9539
- NPI assigned
- Mar 24, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250707001377 | FL | Order and Referring Only - Internal Medicine |
6002320736 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Interoperability endpoints
- siddharth.balaji@hca4.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
5301 S Congress Ave
Atlantis, FL 33462-1149
Mailing address
5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 313-9539
Other providers in Atlantis, FL
- Joshua J Bailin
- Rebecca Bailitz
- Jessica Elizabeth Baken
- Marat Bakman
- Alan E Bakst
- Debra L. Baldwin
- Yasherah Anngell Balgobin
- Sunil Daniel Bali
- Brian Balint
- Jorge Barbaro Barletta Farias
All providers in Atlantis, FL · Student in an Organized Health Care Education/Training Program in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.