Active NPI
Khurrum Siddique, M.D.
- Pediatric Nephrology Physician
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- 036.163809
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 321120302 | Medicaid | TX |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036.163809 | IL | MD | Pediatric Nephrology Physician |
| 2024-01519 | NC | MD | Pediatric Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut Lebonheur Pediatric Specialists, Inc. | Pediatrics | Current | Accepting new patients |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current | Accepting new patients | |
| Baylor College of Medicine | Pediatrics | Current | Accepting new patients |
| McAllen Hospitalist Group, PLLC | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| University of Minnesota Health Clinics and Surgery Center Inc | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | 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
- ksiddique2900004@carolinashealthcaresystem.direct-ci.com
- ksiddique73055@mlh.direct-ci.com
- 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.
-
- Pediatrics Physician
- Memphis, TN
- NPI 1093024101
-
dba M Health Fairview Recovery Clinic
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
dba BCM Physicians of San Antonio
- Pediatrics Physician
- San Antonio, TX
- NPI 1285079764
-
dba Valley Care Clinics
- Internal Medicine Physician
- Edinburg, TX
- NPI 1356361976
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
-
- Clinic/Center
- Minneapolis, MN
- NPI 1053795187
-
dba Advocate Christ Medical Group
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
dba Advocate Children's Hospital
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
dba Fairview Andover Clinic (Eyewear)
- Eyewear Supplier
- Andover, MN
- NPI 1356524540
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
dba University of Minnesota Health Clinics and Surgery Center - Anesthesia
- Anesthesiology Physician
- Minneapolis, MN
- NPI 1003485004
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Fairview Hospital University
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
dba Fairview Diagnostic Laboratory
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1316008212
-
dba University of MN Medical Center, Fairview Transitional Care
- Skilled Nursing Facility
- Minneapolis, MN
- NPI 1669459913
Hospital
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
dba Wake Forest Baptist Medical Center
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
dba Wake Forest Baptist Medical Center
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
dba Winston East Pediatrics
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.