Individual provider Active NPI

Usman Siddiqui, MD

  • Neurology Physician
  • Lawrenceburg, IN
National Provider Identifier
1114927712
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01038155A Issued in IN
Practice address
606 Wilson Creek Rd
Ste. 210
Lawrenceburg, IN 47025-1095
Phone
(812) 537-7011
Fax
(812) 537-7021
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01038155A IN Primary

Addresses

Primary practice location

606 Wilson Creek Rd
Ste. 210
Lawrenceburg, IN 47025-1095

Mailing address

606 Wilson Creek Rd
Ste. 210
Lawrenceburg, IN 47025-1095
Phone (812) 537-7011

Other identifiers 2

IdentifierTypeStateIssuer
100319400MedicaidIN
0937400MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 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
I20100211000270 OH Practitioner - NeurologyPractitioner - Psychiatry 2264441591
I20100510000324 IN Practitioner - NeurologyPractitioner - Psychiatry 2264441591

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01038155AINMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
William L Shoemaker D O a Medical Corporation Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1114927712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 WILSON CREEK RD",
            "address_2": "STE. 210",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470251095",
            "telephone_number": "812-537-7011",
            "fax_number": "812-537-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 WILSON CREEK RD",
            "address_2": "STE. 210",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470251095",
            "telephone_number": "812-537-7011",
            "fax_number": "812-537-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "USMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01038155A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100319400",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0937400",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

Verify at the official NPI Registry.