Individual provider Active NPI

Sabiha T Siddiqui, M.D.

  • Family Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1386669760
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019036727 Issued in MO
Practice address
224 S Woods Mill Rd Ste 570
Chesterfield, MO 63017-3513
Phone
(314) 205-6898
Fax
(314) 590-5911
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2019036727 MO Primary

Addresses

Primary practice location

224 S Woods Mill Rd Ste 570
Chesterfield, MO 63017-3513

Mailing address

# L3571
Columbus, OH 43260-0001
Phone (937) 885-3206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20200416000862 MO Practitioner - Family Practice 0648280297 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

224 S Woods Mill Rd
Chesterfield, MO 63017-3513
Phone (314) 205-6898

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • Surrey Place St Lukes Hospital Skilled Nursing Nursing home, Chesterfield, MO, CCN 265414

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019036727MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SLMG Long Term Group LLC CurrentSince Nov 1, 2020 Accepting new patients
Physician Specialists of St Lukes LLC Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Alison a Clarey DO Inc Past Accepting new patients
Emergency Physicians of St. Luke'S, LLC Family Medicine Past Accepting new patients

Locations

14701 Olive Blvd
Chesterfield, MO 63017
Phone (314) 542-3300

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

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.

Hospital & facility affiliations 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1386669760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "# L3571",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432600001",
            "telephone_number": "937-885-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD STE 570",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173513",
            "telephone_number": "314-205-6898",
            "fax_number": "314-590-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SABIHA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019036727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.