Mohammed Nasiruddin Siddiqui, MD FACS

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C51828 Issued in CA

Practice address

609 New York Ranch Rd
Jackson, CA 95642-9328

Phone

(209) 257-0301

Fax

(209) 257-0302

NPI assigned

Nov 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mohammed Siddiqui, M.D. a Professional Corporation

  • Specialist
  • Jackson, CA
  • NPI 1326219361
  Authorized official Same address or phone
• Shanti Siddiqui, M.D. a Professional Corporation

  • Specialist
  • Jackson, CA
  • NPI 1407027444
  NPD (past)

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366513426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-257-0301",
            "fax_number": "209-257-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429328",
            "telephone_number": "209-257-0301",
            "fax_number": "209-257-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MOHAMMED",
        "middle_name": "NASIRUDDIN",
        "name_prefix": "Dr.",
        "credential": "MD FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C51828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Sharp, MS, PPS
• Julia Ann Shelby, NP
• Gary G Shi, MD, PHD
• Jennifer Monique Shoemaker, MD
• Anisa Shoghi Ghaleh Shahi, PHARMD
• Shanti Siddiqui, M.D.
• Kevin Sidhu, DO
• Christopher P. Sienes, D.C.
• Sierra Child & Family Services
• Sierra Child & Family Services

• Surgery Physician in Jackson, CA
• Providers in Jackson, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.