Individual provider Active NPI

Khurrum Siddique, M.D.

  • Pediatric Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1154640324
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
036.163809 Issued in IL
Practice address
333 N Santa Rosa
San Antonio, TX 78207-3108
Phone
(210) 704-3030
NPI assigned
May 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 036.163809 IL Primary
Pediatrics Physician 208000000X P6084 TX
Pediatric Nephrology Physician 2080P0210X 2024-01519 NC
Pediatric Nephrology Physician 2080P0210X P6084 TX

Addresses

Primary practice location

333 N Santa Rosa
San Antonio, TX 78207-3108

Mailing address

333 N Santa Rosa
San Antonio, TX 78207-3108
Phone (210) 704-3030

Other practice location 1

2821 Michaelangelo Dr Ste 101
Edinburg, TX 78539-1411
Phone (956) 362-8200

Other practice location 2

9555 S 52nd Ave
Oak Lawn, IL 60453-3054
Phone (708) 684-5437

Other practice location 3

Medical Center Blvd
Winston Salem, NC 27157-3108
Phone (336) 713-4500

Other identifiers 1

IdentifierTypeStateIssuer
321120302MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ksiddique370527@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL, TN, MN4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20151203000486 TX Practitioner - Pediatric MedicinePractitioner - Nephrology 4486954013 Reassigns benefits to 2 organizations
I20230425002068 IL Practitioner - Pediatric Medicine 4486954013 Reassigns benefits to 1 organization
I20240729000883 TN Practitioner - Pediatric MedicinePractitioner - Nephrology 4486954013 Reassigns benefits to 1 organization
I20260115003553 MN Practitioner - NephrologyPractitioner - Pediatric Medicine 4486954013 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-7422

51 N Dunlap St
Memphis, TN 38105-4625
Phone (901) 287-7337

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.163809ILMDPediatric Nephrology Physician
2024-01519NCMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatrics CurrentSince May 9, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 26, 2023 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Mar 26, 2023 Accepting new patients
Baylor College of Medicine Pediatrics CurrentSince Sep 20, 2022 Accepting new patients
McAllen Hospitalist Group, PLLC CurrentSince Jan 3, 2023 Accepting new patients
Fairview Express Care CurrentSince Jan 8, 2026 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 8, 2026 Accepting new patients
Fairview Express Care CurrentSince Jan 8, 2026 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 8, 2026 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 8, 2026 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

848 Adams Ave
Memphis, TN 38103
Phone (901) 287-5437

1102 W Trenton Rd
Edinburg, TX 78539
Phone (956) 388-6500

2110 W Trenton Rd
Ste B
Edinburg, TX 78539
Phone (610) 382-4422

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Interoperability endpoints

  • Direct secure messaging: ksiddique2900004@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: ksiddique73055@mlh.direct-ci.com
  • Direct secure messaging: ksiddique420658@christushealth.direct-ci.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1154640324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2821 Michaelangelo Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785391411",
            "country_code": "US",
            "telephone_number": "956-362-8200",
            "fax_number": "956-362-8204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9555 S 52nd Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533054",
            "country_code": "US",
            "telephone_number": "708-684-5437",
            "fax_number": "708-876-1569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271573108",
            "country_code": "US",
            "telephone_number": "336-713-4500",
            "fax_number": "336-713-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "KHURRUM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": "036.163809",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P6084",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NC",
            "license": "2024-01519",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "P6084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321120302",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksiddique370527@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.