Individual provider Active NPI

Anila Qaiser Siddiqui, M.D.

  • Neurology Physician
  • East Meadow, NY
National Provider Identifier
1417127333
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
242229 Issued in NY
Practice address
380 Merrick Ave
East Meadow, NY 11554-2701
Phone
(516) 279-6210
Fax
(516) 596-8979
NPI assigned
Mar 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 242229 NY Primary
Clinical Neurophysiology Physician 2084N0600X 242229 NY
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 242229 NY

Addresses

Primary practice location

380 Merrick Ave
East Meadow, NY 11554-2701

Mailing address

380 Merrick Ave
East Meadow, NY 11554-2701
Phone (516) 279-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090206000396 NY Practitioner - Neurology 0941365944 Reassigns benefits to 2 organizations
Practice locations: Richmond Hill, NY; Lindenhurst, NY

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11617 Atlantic Ave
Richmond Hill, NY 11418-3141
Phone (516) 279-6210

910 Route 109 B
Lindenhurst, NY 11757-1158
Phone (516) 279-6210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242229NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince May 19, 2009 Accepting new patients
All Island Neurology PC Neurology CurrentSince Mar 11, 2015 Accepting new patients
Nassau Health Care Corporation CurrentSince May 19, 2009 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients

Locations

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

380 Merrick Ave
East Meadow, NY 11554
Phone (516) 279-6210

11617 Atlantic Ave
Ste 100
Richmond Hill, NY 11418

11617 Atlantic Ave
Richmond Hill, NY 11418
Phone (516) 279-6210

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHFCAD/Endpoint/IHFCAD

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": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1417127333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MERRICK AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542701",
            "telephone_number": "516-279-6210",
            "fax_number": "516-596-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MERRICK AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542701",
            "telephone_number": "516-279-6210",
            "fax_number": "516-596-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ANILA",
        "middle_name": "QAISER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "242229",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "242229",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NY",
            "license": "242229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.