Fazeel Mukhtar Siddiqui, M.D.

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

4301116960 Issued in MI

Practice address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Phone

(616) 252-7200

NPI assigned

Aug 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Neurology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fsiddiqui3346821@direct.trinity-health.org

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.

• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment Care Compare group NPD
• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD
• Munson Medical Center

  • Neurological Surgery Physician
  • Traverse City, MI
  • NPI 1942685045
  NPD
• Metropolitan Hospital

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1114947538
  NPD (past)
• Metropolitan Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Wyoming, MI
  • NPI 1336182542
  NPD (past)
• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  NPD (past)

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

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1154513687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 HEALTH DR SW STE 160",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199402",
            "telephone_number": "616-252-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2122 Health Dr SW Ste 160",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199402",
            "country_code": "US",
            "telephone_number": "616-252-5790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842360",
            "country_code": "US",
            "telephone_number": "231-392-0640",
            "fax_number": "231-392-0643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Cherry St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034608",
            "country_code": "US",
            "telephone_number": "616-685-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "FAZEEL",
        "middle_name": "MUKHTAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-132058",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036-132058",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MI",
            "license": "4301116960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036132058",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanaya Sharee Shepherd
• Stanley R Sherman, M.D.
• Brendan James Sherry, PA-C
• Spencer Andrew Shillinglaw, DO
• Nichole Shroll
• Jason Douglas Sikkema, MA MLP
• Mercy Simmons
• Samantha Ann Simon, MLP
• Michelle Lynn Simons, MSW, LMSW
• Simply a Loving Touch Home Care Services, LLC

• Vascular Neurology Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Vascular Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.