Individual provider Active NPI

Sameer Ahmed Siddiqi, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Flemington, NJ
National Provider Identifier
1417368499
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
25MB10560200 Issued in NJ
Practice address
2100 Wescott Dr
Flemington, NJ 08822-4603
Phone
(908) 788-6410
Fax
(908) 788-6361
NPI assigned
May 13, 2014
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MB10560200 NJ Primary

Addresses

Primary practice location

2100 Wescott Dr
Flemington, NJ 08822-4603

Mailing address

2100 Wescott Dr
Flemington, NJ 08822-4603
Phone (315) 271-9422

Other practice location 1

1945 State Route 33
Neptune, NJ 07754
Phone (732) 776-4483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190731001115 NJ Practitioner - AnesthesiologyPractitioner - Pain Management 4789930066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2100 Wescott Dr
Flemington, NJ 08822-4603
Phone (908) 788-6100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Pain & Anesthesia LLC Pain Medicine CurrentSince Jun 15, 2022 Accepting new patients

Locations

1121 Route 22
Ste 204
Bridgewater, NJ 08807
Phone (908) 237-4130

2100 Wescott Dr
Flemington, NJ 08822
Phone (908) 237-5420

Interoperability endpoints

  • Direct secure messaging: sameer.siddiqi.p59@direct.hunterdon.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1417368499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DR",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224603",
            "telephone_number": "315-271-9422",
            "fax_number": "732-776-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DR",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224603",
            "telephone_number": "908-788-6410",
            "fax_number": "908-788-6361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 State Route 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "07754",
            "country_code": "US",
            "telephone_number": "732-776-4483",
            "fax_number": "732-776-4798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SAMEER",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MB10560200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flemington, NJ

Sources for this page

Verify at the official NPI Registry.