Individual provider Active NPI

Rana Siddabattuni, M.D.

  • Internal Medicine Physician
  • Miami Gardens, FL
National Provider Identifier
1376700203
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME160125 Issued in FL
Practice address
4692 NW 183Rd St
Miami Gardens, FL 33055-3054
Phone
(786) 625-7774
Fax
(786) 625-7714
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME160125 FL Primary

Addresses

Primary practice location

4692 NW 183Rd St
Miami Gardens, FL 33055-3054

Mailing address

4692 NW 183Rd St
Miami Gardens, FL 33055-3054
Phone (786) 625-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 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
I20171017001078 NY Practitioner - Internal Medicine 9133397805 Reassigns benefits to 1 organization
I20240524003341 FL Practitioner - Internal Medicine 9133397805 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 11, 2017 Accepting new patients
Chen Neighborhood Medical Centers of South Florida, LLC CurrentSince Jun 1, 2024 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Aug 11, 2017 Accepting new patients
Chen Neighborhood Medical Centers of South Florida LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

20801 NW 2nd Ave
Miami Gardens, FL 33169

4692 NW 183rd St
Miami Gardens, FL 33055
Phone (305) 405-6020

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

6037 Kimberly Blvd
North Lauderdale, FL 33068
Phone (954) 379-8994

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: rsiddabattuni@landmarkhealth-direct.org

Organizations & group practices 4

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1376700203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330553054",
            "telephone_number": "786-625-7774",
            "fax_number": "786-625-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 NW 183RD ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330553054",
            "telephone_number": "786-625-7774",
            "fax_number": "786-625-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDABATTUNI",
        "first_name": "RANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.