Individual provider Active NPI

Kashif Ahmed Siddiqui, MD

  • Emergency Medicine Physician
  • Pearland, TX
National Provider Identifier
1154636561
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P2788 Issued in TX
Practice address
11601 Shadow Creek Pkwy
Suite # 111-139
Pearland, TX 77584-7283
Phone
(832) 462-9574
Fax
(281) 786-3939
NPI assigned
Aug 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27031 OK
Family Medicine Physician 207Q00000X P2788 TX
Geriatric Medicine (Internal Medicine) Physician 207RG0300X P2788 TX
Student in an Organized Health Care Education/Training Program 390200000X BP10034162 TX
Emergency Medicine Physician 207P00000X P2788 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X 27031 OK

Addresses

Primary practice location

11601 Shadow Creek Pkwy
Suite # 111-139
Pearland, TX 77584-7283

Mailing address

2405 Barton Shore Dr
Pearland, TX 77584-3952
Phone (832) 462-9574

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
I20120509000177 TX Practitioner - Family Practice 5092977066 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
ZN Healthcare Services PLLCGroup PAC ID 7719394295, 2 clinicians

Practice addresses (Care Compare)

3129 Kingsley Dr
Suite 340
Pearland, TX 77584-8506
Phone (346) 800-5148

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
TK Emergency Physicians Group PLLC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
ZN Healthcare Services, PLLC Family Medicine CurrentSince Mar 1, 2021 Accepting new patients
Texas ER Group PLLC Emergency Medicine CurrentSince May 17, 2024 Accepting new patients
Optimum Ambulatory Health PLLC CurrentSince Feb 9, 2023 Accepting new patients
Medical Center Emergency Physicians PA Emergency Medicine Past Accepting new patients
Southwest Medical Associates, Inc. Emergency Medicine Past Accepting new patients

Locations

14120 FM 2100 Rd
Crosby, TX 77532
Phone (281) 328-7770

2409 Falcon Pass Dr
Ste 100
Houston, TX 77062
Phone (281) 461-1111

1535 West Loop S
Ste 300
Houston, TX 77027
Phone (713) 961-0423

137 N Lhs Dr
Ste 755
Lumberton, TX 77657
Phone (832) 219-3833

220 Blanco St
Ste 2
Lumberton, TX 77657
Phone (409) 755-2273

11233 Shadow Creek Pkwy
Ste 313
Pearland, TX 77584
Phone (346) 352-5100

3129 Kingsley Dr
Ste 340
Pearland, TX 77584
Phone (346) 209-0885

22678 Highway 59
Porter, TX 77365
Phone (281) 354-4654

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.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1154636561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 BARTON SHORE DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775843952",
            "telephone_number": "832-462-9574",
            "fax_number": "281-786-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 SHADOW CREEK PKWY",
            "address_2": "SUITE # 111-139",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847283",
            "telephone_number": "832-462-9574",
            "fax_number": "281-786-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "KASHIF",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "27031",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P2788",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "P2788",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10034162",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P2788",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "27031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.