Shad Siddiqi, DO

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

5101024603 Issued in MI

Practice address

22250 Providence Dr Ste 401
Southfield, MI 48075-6212

Phone

(866) 974-2673

Fax

(866) 939-2673

NPI assigned

May 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Pain ManagementAlso: Anesthesiology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Porretta Center for Orthopaedic Surgery, PLLCGroup PAC ID 2860585544, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Michigan Surgical Hospital LLC Hospital, Warren, MI, CCN 230264
• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
• Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022

Merit-based Incentive Payment System (MIPS)

Final score

89.4 of 100Reported as individual

Quality

82.94

Promoting interoperability

100

Improvement activities

40

Cost

81.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shad.siddiqi.1@22724.direct.athenahealth.com
• Direct secure messaging: ssiddiqi2753562@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.

• The Porretta Center for Orthopaedic Surgery, PLLC

  • Orthopaedic Surgery Physician
  • Novi, MI
  • NPI 1306818331
  Medicare reassignment Care Compare group NPD
• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment NPD
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
  • NPI 1114667763
  NPD
• The Porretta Center for Orthopaedic Surgery, PLLC

  • Customized Equipment (DME)
  • Howell, MI
  • NPI 1407428584
  NPD
• Medical X-Ray Consultants, LTD

  • Vascular & Interventional Radiology Physician
  • Alexandria, MN
  • NPI 1386601383
  NPD (past)

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

• Community Health Center of Branch County

  • General Acute Care Hospital
  • Coldwater, MI
  • NPI 1063471639
  Care Compare affiliation
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• Southeast Michigan Surgical Hospital, LLC

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1962402354
  Care Compare affiliation

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1154733285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 401",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756212",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SHAD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101024603",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "5101024603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marylin Ruth Shuster, PA
• Denise Shuttie, M.D.
• Nezylle Sia
• Marites Sibug-Franklin
• Jeffrey P Sickles, RN CRNA
• Mohamed S Siddique, MD
• Firdous Anjum Siddiqui, MD
• Mukarram Mohammed Siddiqui, MD
• Sana Siddiqui, PT
• Zaki H Siddiqui

• Interventional Pain Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Interventional Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.