Individual provider Active NPI

Khwaja Ahmeruddin Siddiqui, M.D

  • Neurology Physician
  • Houston, TX
National Provider Identifier
1124480082
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
S5073 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2358
Phone
(832) 824-1000
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X S5073 TX
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X S5073 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2358

Mailing address

7200 Cambridge St FL 10
Houston, TX 77030-4202
Phone (713) 798-1750

Other practice location 1

7200 Cambridge St Fl 10
Houston, TX 77030-4202
Phone (713) 798-1750 ext. 2

Other practice location 2

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 798-1750 ext. 2

Other practice location 3

36 McKenna Dr
North Billerica, MA 01862-1731
Phone (617) 650-6812

Other practice location 4

1101 Bates Ave
Houston, TX 77030-2607
Phone (832) 355-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220614002780 TX Practitioner - NeurologyPractitioner - Critical Care (Intensivists) 0941689426 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Critical Care (Intensivists)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

6651 Main St
Houston, TX 77030-2351
Phone (832) 826-3000

7200 Cambridge St
FL 10
Houston, TX 77030-4202
Phone (713) 798-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jun 1, 2022 Accepting new patients
Texas Children'S Physician Group CurrentSince May 3, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Jun 1, 2022 Accepting new patients
Baylor College of Medicine Neurology CurrentSince Jun 1, 2022 Accepting new patients
Baylor College of Medicine CurrentSince Jun 1, 2022 Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

7200 Cambridge St
Houston, TX 77030
Phone (713) 798-2400

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

1101 Bates Ave
Houston, TX 77030
Phone (713) 798-1300

1504 Taub Loop
#285
Houston, TX 77030
Phone (713) 873-2626

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1124480082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST FL 10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202",
            "telephone_number": "713-798-1750",
            "fax_number": "713-798-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302358",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Cambridge St Fl 10",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304202",
            "country_code": "US",
            "telephone_number": "713-798-1750 x2",
            "fax_number": "713-798-4693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1504 Taub Loop",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301608",
            "country_code": "US",
            "telephone_number": "713-798-1750 x2",
            "fax_number": "713-798-4693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36 McKenna Dr",
            "address_purpose": "LOCATION",
            "city": "North Billerica",
            "state": "MA",
            "postal_code": "018621731",
            "country_code": "US",
            "telephone_number": "617-650-6812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Bates Ave",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302607",
            "country_code": "US",
            "telephone_number": "832-355-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "KHWAJA",
        "middle_name": "AHMERUDDIN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "TX",
            "license": "S5073",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "S5073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.