Active NPI
Kanwal Siddiqui, M.D.
- Student in an Organized Health Care Education/Training Program
- Miami, FL
National Provider Identifier
1154764447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1611 NW 12TH Ave
West Wing 279
Miami, FL 33136-1005 - Phone
- (305) 585-7955
- NPI assigned
- Apr 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 020580 | PR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1611 NW 12TH Ave
West Wing 279
Miami, FL 33136-1005
Mailing address
1611 NW 12TH Ave
West Wing 279
Miami, FL 33136-1005
Phone (305) 585-7955
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230518003052 | TX | Order and Referring Only - Nuclear Medicine | 9436515327 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020580 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1154764447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "WEST WING 279",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-585-7955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NW 12TH AVE",
"address_2": "WEST WING 279",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "305-585-7955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDDIQUI",
"first_name": "KANWAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-17",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "020580",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.