Individual provider Active NPI

Nazia Yasmin Sidiq, D.O.

  • Family Medicine Physician
  • Bowling Green, OH
National Provider Identifier
1184602377
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.008687 Issued in OH
Practice address
1039 Haskins Rd
Suite a
Bowling Green, OH 43402-9065
Phone
(419) 352-1121
Fax
(419) 352-1179
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.008687 OH Primary

Addresses

Primary practice location

1039 Haskins Rd
Suite a
Bowling Green, OH 43402-9065

Mailing address

745 Haskins Rd
Suite B
Bowling Green, OH 43402-1637
Phone (419) 353-7069

Other identifiers 2

IdentifierTypeStateIssuer
2621112MedicaidOH
DA5101OtherOHRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nazia.sidiq.p1@direct.whc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060123000286 OH Practitioner - Family Practice 7113941790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

660 Beaver Creek Cir
Suite 110
Maumee, OH 43537-1746
Phone (419) 891-6210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.008687OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Family Medicine CurrentSince Mar 1, 2026 Accepting new patients
Promedica Central Physicians CurrentSince Mar 1, 2026 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

660 Beaver Creek Cir
Ste 110
Maumee, OH 43537
Phone (419) 891-6210

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.

Hospital & facility affiliations 2

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1184602377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 HASKINS RD",
            "address_2": "SUITE B",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434021637",
            "telephone_number": "419-353-7069",
            "fax_number": "419-353-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 HASKINS RD",
            "address_2": "SUITE A",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434029065",
            "telephone_number": "419-352-1121",
            "fax_number": "419-352-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDIQ",
        "first_name": "NAZIA",
        "middle_name": "YASMIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.008687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2621112",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA5101",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nazia.sidiq.p1@direct.whc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1039 Haskins Rd",
            "address_2": "Suite A",
            "city": "Bowling Green",
            "state": "OH",
            "country_code": "US",
            "postal_code": "434029065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

Verify at the official NPI Registry.