Individual provider Active NPI

Nouman Siddiqui, M.D.

  • Ophthalmology Physician
  • Raleigh, NC
National Provider Identifier
1144270083
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
200300882 Issued in NC
Practice address
4201 Lake Boone TRL
Suite 205
Raleigh, NC 27607-7512
Phone
(919) 859-8436
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 200300882 NC Primary

Addresses

Primary practice location

4201 Lake Boone TRL
Suite 205
Raleigh, NC 27607-7512

Mailing address

4201 Lake Boone TRL
Suite 205
Raleigh, NC 27607-7512
Phone (919) 859-8436

Other identifiers 1

IdentifierTypeStateIssuer
89-134NAMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20051101001002 NC Practitioner - Ophthalmology 0941275648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Duke University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4201 Lake Boone TRL
Suite 205
Raleigh, NC 27607-7511
Phone (919) 659-8436

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.22 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
67.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200300882NCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glaucoma and Cataract Associates of North Carolina, PC Ophthalmology CurrentSince Jul 1, 2012 Accepting new patients

Locations

4201 Lake Boone Trl
Ste 205
Raleigh, NC 27607
Phone (919) 571-6460

Organizations & group practices 1

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 1

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1144270083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "SUITE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-859-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "SUITE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-859-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "NOUMAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200300882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-134NA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.