Individual provider Active NPI

M. Salim Un-Nabi Siddiqui, M.D., PH.D.

  • Radiation Oncology Physician
  • Detroit, MI
National Provider Identifier
1396010922
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301091890 Issued in MI
Practice address
2799 W Grand Blvd Dept of
Henry Ford Hospital
Detroit, MI 48202-2608
Phone
(313) 916-1015
Fax
(313) 916-3235
NPI assigned
Mar 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 4301091890 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd Dept of
Henry Ford Hospital
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd Dept of
Henry Ford Hospital
Detroit, MI 48202-2608
Phone (313) 916-1015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120719000358 MI Practitioner - Radiation Oncology 9436315462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Temple University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-6677

1102 E Michigan Ave
Jackson, MI 49201-1802
Phone (517) 205-7299

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

19675 Allen Rd
Brownstown TWP, MI 48183-1021
Phone (734) 479-3311

2799 W Grand Blvd
Detroit, MI 48202-2608

6773 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6100

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6470

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091890MIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Aug 1, 2012 Accepting new patients
W a Foote Memorial Hospital Inc Radiation Oncology CurrentSince Aug 17, 2019 Accepting new patients
Henry Ford Health System CurrentSince Aug 1, 2012 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Aug 17, 2019 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System Current Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

19675 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-3311

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#5
Detroit, MI 48202
Phone (313) 916-2710

2800 W Grand Blvd
Detroit, MI 48202
Phone (313) 230-1078

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1102 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-7299

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: msiddiqui14130@direct.hfhs.org

Organizations & group practices 8

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 5

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": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1396010922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD DEPT OF",
            "address_2": "HENRY FORD HOSPITAL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1015",
            "fax_number": "313-916-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD DEPT OF",
            "address_2": "HENRY FORD HOSPITAL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1015",
            "fax_number": "313-916-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "M. SALIM",
        "middle_name": "UN-NABI",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301091890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.