Ashfaq H Siddiqui, MD FACS

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

L5562 Issued in TX

Practice address

309 Regency Pkwy
Suite 207
Mansfield, TX 76063-5165

Phone

(817) 225-2716

Fax

(817) 225-2719

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Vascular SurgeryAlso: General Surgery, Thoracic Surgery

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Greenbrier Valley Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ronceverte, WV
  • NPI 1760676407
  NPD (past)
• Greenbrier VMC LLC

  dba Greenbrier Valley Medical Center

  • Internal Medicine Physician
  • Ronceverte, WV
  • NPI 1275546996

  Vascular Surgery

  NPD (past)
• Greenbrier VMC LLC

  • Surgery Physician
  • Lewisburg, WV
  • NPI 1417153172
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1417952623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 REGENCY PKWY",
            "address_2": "SUITE 207",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635165",
            "telephone_number": "817-225-2716",
            "fax_number": "817-225-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 REGENCY PKWY",
            "address_2": "SUITE 207",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635165",
            "telephone_number": "817-225-2716",
            "fax_number": "817-225-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ASHFAQ",
        "middle_name": "H",
        "credential": "MD FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "L5562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1488594",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00439527",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0057PA",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00439527",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1919615",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Derae Sheppard, DDS
• Alicia E Sherin, LMT AND MMP
• Staceyann Wade Shoemake, M.S. CCC-SLP
• Jakeitha Shoemaker
• Yashoda Shrestha, FNP-C
• Khadija Siddiqui, D.O
• Signature Pointe Psychiatric and Mental Health PLLC
• Cheryl Marie Silva, DC
• Jose De Jesus Silva, DC
• Isabelle Laure Simeni, AGACNP

• Vascular Surgery Physician in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.