Individual provider Active NPI

Khaleeq Hussain Siddiqui, M.D.

  • Gastroenterology Physician
  • Stockton, CA
National Provider Identifier
1174803563
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C161602 Issued in CA
Practice address
782 E Harding Way
Stockton, CA 95204-6101
Phone
(209) 546-5200
Fax
(209) 466-1982
NPI assigned
Aug 17, 2011
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C161602 CA
Gastroenterology Physician 207RG0100X C161602 CA Primary

Addresses

Primary practice location

782 E Harding Way
Stockton, CA 95204-6101

Mailing address

3400 Data Dr
Attention: Credentialing and Payer Enrollment Dept
Rancho Cordova, CA 95670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190806004153 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0345577854 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

782 E Harding Way
Stockton, CA 95204-6101
Phone (209) 546-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C161602CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Multi-Specialty Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2024 Accepting new patients
Lodi Memorial Hospital Association Inc Multi-Specialty CurrentSince Dec 15, 2024 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2024 Accepting new patients
Dignity Health Medical Foundation Multi-Specialty CurrentSince Feb 16, 2026 Accepting new patients
Lodi Memorial Hospital Association, Inc Multi-Specialty Current Accepting new patients
Dignity Health Medical Foundation Multi-Specialty CurrentSince Feb 16, 2026 Accepting new patients
Inpatient Specialists of California, PC Multi-Specialty CurrentSince Jul 1, 2019 Accepting new patients

Locations

621 S Ham Ln
Ste A
Lodi, CA 95242
Phone (209) 334-8514

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

999 S Fairmont Ave
Ste 50
Lodi, CA 95240
Phone (209) 334-8509

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

1901 N California St
Stockton, CA 95204
Phone (209) 946-6800

782 E Harding Way
Stockton, CA 95204
Phone (209) 475-5500

Organizations & group practices 9

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": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1174803563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "782 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046101",
            "telephone_number": "209-546-5200",
            "fax_number": "209-466-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "KHALEEQ",
        "middle_name": "HUSSAIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C161602",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C161602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.