Individual provider Active NPI

Farhat S. Siddiqui, M.D.

  • Psychiatry Physician
  • Everett, WA
National Provider Identifier
1174886568
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD61005393 Issued in WA
Practice address
1728 W Marine View Dr Ste 106
Everett, WA 98201-2094
Phone
(425) 339-5453
Fax
(425) 252-4441
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Q9737 TX
Psychiatry Physician 2084P0800X MD61005393 WA Primary

Addresses

Primary practice location

1728 W Marine View Dr Ste 106
Everett, WA 98201-2094

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 339-5453

Other practice location 1

500 University Dr
McH073
Hershey, PA 17033-2360
Phone (717) 531-4120

Other practice location 2

500 University Dr
McH073
Hershey, PA 17033-2360
Phone (717) 531-4120

Other practice location 3

9401 Southwest Fwy
Houston, TX 77074-1407
Phone (713) 970-7000

Other identifiers 1

IdentifierTypeStateIssuer
376401101MedicaidTX

Other names 1

  • Farhat Shaheen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200128001314 WA Practitioner - Psychiatry 1254612872 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Jan 20, 2020 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 20, 2020 Accepting new patients
Optum Care Washington PLLC PastSince Jan 12, 2020 Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1728 W Marine View Dr
Everett, WA 98201
Phone (425) 252-9216

1728 W Marine View Dr
Ste 106
Everett, WA 98201

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: fsiddiqui18336@direct.tecmc.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1174886568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-339-5453",
            "fax_number": "425-252-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 W MARINE VIEW DR STE 106",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012094",
            "telephone_number": "425-339-5453",
            "fax_number": "425-252-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_2": "MCH073",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-4120",
            "fax_number": "717-531-6491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Dr",
            "address_2": "MCH073",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-4120",
            "fax_number": "717-531-6491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9401 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770741407",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "fax_number": "713-970-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "FARHAT",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q9737",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61005393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376401101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FARHAT",
            "last_name": "SHAHEEN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.