Individual provider Active NPI

Omar K Siddiqi, MD

  • Neurology Physician
  • Boston, MA
National Provider Identifier
1356538417
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
234167 Issued in MA
Practice address
330 Brookline Avenue
Beth Israel Deaconess Medical Center
Boston, MA 02215
Phone
(617) 667-7000
NPI assigned
Oct 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 234167 MA Primary
Clinical Neurophysiology Physician 2084N0600X 234167 MA

Addresses

Primary practice location

330 Brookline Avenue
Beth Israel Deaconess Medical Center
Boston, MA 02215

Mailing address

330 Mount Auburn St # 2
Cambridge, MA 02138-5597
Phone (617) 868-0880

Other practice location 1

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Other practice location 2

300 Mount Auburn St Ste 316
Cambridge, MA 02138-5665
Phone (617) 868-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20090504000310 MA Practitioner - Neurology 4284782194 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Rochester School of Medicine and Dentistry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians
Seacoast Affiliated Group Practice IncGroup PAC ID 1658357843, 50 clinicians

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

21 Highland Ave
Newburyport, MA 01950-3873
Phone (978) 255-4217

25 Highland Ave
Newburyport, MA 01950-3867
Phone (978) 834-8074

275 Sandwich St
Plymouth, MA 02360-2183
Phone (781) 983-9088

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

600 Unicorn Park Dr
Woburn, MA 01801-3376

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc Neurology CurrentSince Jun 4, 2009 Accepting new patients
Seacoast Affiliated Group Practice, Inc. CurrentSince Dec 2, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jun 4, 2009 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Mount Auburn Professional Services Inc Neurology CurrentSince Apr 30, 2024 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Jan 1, 2026 Accepting new patients
Mt Auburn Professional Services Neurology CurrentSince Apr 30, 2024 Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

300 Mount Auburn St
Ste 316
Cambridge, MA 02138
Phone (617) 868-0880

330 Mount Auburn St
#2
Cambridge, MA 02138
Phone (617) 499-5026

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

21 Highland Ave
Ste 5
Newburyport, MA 01950
Phone (978) 255-4217

25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: osiddiqi252952@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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 3

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": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1356538417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST # 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385597",
            "telephone_number": "617-868-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVENUE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Mount Auburn St Ste 316",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021385665",
            "country_code": "US",
            "telephone_number": "617-868-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "OMAR",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "234167",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MA",
            "license": "234167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.