Active NPI
Mahmood Siddique, M.D.
- Anesthesiology Physician
- Philadelphia, PA
National Provider Identifier
1235114059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD055412L
- Practice address
- 7600 Central Ave
Philadelphia, PA 19111-2442 - Phone
- (215) 728-3714
- Fax
- (215) 728-3923
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD055412L | PA | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | MD055412L | PA |
Addresses
Primary practice location
7600 Central Ave
Philadelphia, PA 19111-2442
Mailing address
1271 Tressler Dr
Fort Washington, PA 19034-1729
Phone (215) 728-3714
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015575330002 | Medicaid | PA |
Other names 1
- Mahmood S Siddique
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eminence Anesthesia LLC | Anesthesiology | Past | Accepting new patients |
Interoperability endpoints
- mahmood.siddique.1@18824.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Forsyth, GA
- NPI 1497219240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454976000000",
"number": "1235114059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1271 TRESSLER DR",
"city": "FORT WASHINGTON",
"state": "PA",
"postal_code": "190341729",
"telephone_number": "215-728-3714",
"fax_number": "215-728-3923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 CENTRAL AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191112442",
"telephone_number": "215-728-3714",
"fax_number": "215-728-3923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDDIQUE",
"first_name": "MAHMOOD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2016-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD055412L",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "PA",
"license": "MD055412L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015575330002",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAHMOOD",
"last_name": "SIDDIQUE",
"middle_name": "S",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.