Individual provider Active NPI

Aqeel M Siddiqui, M.D.

  • Vascular Surgery Physician
  • Brockton, MA
National Provider Identifier
1164416186
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
152210 Issued in MA
Practice address
830 Oak St Ste 200W
Brockton, MA 02301-1191
Phone
(774) 480-1600
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 152210 MA Primary

Addresses

Primary practice location

830 Oak St Ste 200W
Brockton, MA 02301-1191

Mailing address

830 Oak St Ste 200W
Brockton, MA 02301-1191
Phone (774) 480-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050811000706 MA Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Peripheral Vascular DiseasePractitioner - Undersea and Hyperbaric Medicine 3779512579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery, Peripheral Vascular Disease, Undersea and Hyperbaric Medicine
Education
University of Massachusetts Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqeel M Siddiqui MD LTDGroup PAC ID 8325290869, 3 clinicians

Practice addresses (Care Compare)

830 Oak St
Suite 200W
Brockton, MA 02301-1191
Phone (774) 480-1600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.27 of 100Reported as group
Improvement activities
40
Cost
79.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal67
Leg revascularization (restoring blood flow)92
Removal of tissue56
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aqeel M Siddiqui MD LTD Vascular Surgery CurrentSince Sep 16, 2012 Accepting new patients
Boston Medical Center - South Corporation Past Accepting new patients

Locations

830 Oak St
Ste 200W
Brockton, MA 02301
Phone (508) 586-7334

Interoperability endpoints

  • Direct secure messaging: aqeel.siddiqui.1@32236.direct.athenahealth.com
  • Direct secure messaging: aqeel.siddiqui@direct.signature.masshiway.net
  • Direct secure messaging: aqeel.siddiqui@vcs.directbygreenway.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1164416186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 OAK ST STE 200W",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011191",
            "telephone_number": "774-480-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OAK ST STE 200W",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011191",
            "telephone_number": "774-480-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AQEEL",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "152210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.