Individual provider Active NPI

Maqsood Ahmed Siddique, MD

  • Cardiovascular Disease Physician
  • Tampa, FL
National Provider Identifier
1346201084
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME 61681 Issued in FL
Practice address
13000 Bruce B Downs Blvd
James a Haley VA Medical Center
Tampa, FL 33612-4745
Phone
(813) 972-7618
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X LT22164 ND
Cardiovascular Disease Physician 207RC0000X ME 61681 FL Primary

Addresses

Primary practice location

13000 Bruce B Downs Blvd
James a Haley VA Medical Center
Tampa, FL 33612-4745

Mailing address

19012 Saint Laurent Dr
Lutz, FL 33558-2809
Phone (813) 949-1613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051129000314 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6002836657 Reassigns benefits to 1 organization
I20250220002396 ND Practitioner - Cardiovascular Disease (Cardiology) 6002836657 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 61681FLMDCardiovascular Disease Physician
LT22164NDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Feb 1, 2025 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 12, 2022 Accepting new patients
Sanford Medical Center Fargo CurrentSince Feb 1, 2025 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

2 Tampa General Cir
Fl 2
Tampa, FL 33606
Phone (813) 209-8596

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: msiddique252773@direct.tgh.org

Organizations & group practices 7

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1346201084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19012 SAINT LAURENT DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335582809",
            "telephone_number": "813-949-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "address_2": "JAMES A HALEY VA MEDICAL CENTER",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745",
            "telephone_number": "813-972-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "MAQSOOD",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2025-02-13",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ND",
            "license": "LT22164",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME 61681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.