Individual provider Active NPI

Sanila Shoaib Siddiqui, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1316760697
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9119600 Issued in FL
Practice address
8690 Point Cypress Dr Ste 110
Orlando, FL 32836-5409
Phone
(407) 566-1616
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9119600 FL Primary

Addresses

Primary practice location

8690 Point Cypress Dr Ste 110
Orlando, FL 32836-5409

Mailing address

8690 Point Cypress Dr Ste 110
Orlando, FL 32836-5409
Phone (407) 566-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126003174 FL Practitioner - Physician Assistant 5496280588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9119600FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Schweiger Dermatology Group PA CurrentSince Nov 10, 2024 Accepting new patients

Locations

410 Celebration Pl
Ste 301
Kissimmee, FL 34747
Phone (407) 566-1616

8690 Point Cypress Dr
Ste 110
Orlando, FL 32836
Phone (407) 566-1616

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1316760697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8690 POINT CYPRESS DR STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365409",
            "telephone_number": "407-566-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8690 POINT CYPRESS DR STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365409",
            "telephone_number": "407-566-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SANILA",
        "middle_name": "SHOAIB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9119600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.