Individual provider Active NPI

Anees Ahmed Siddiqui, M.D.

  • Pediatric Gastroenterology Physician
  • Austin, TX
National Provider Identifier
1447462940
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
M4943 Issued in TX
Practice address
1301 Barbara Jordan Blvd
Suite #200
Austin, TX 78723-3077
Phone
(512) 628-1810
Fax
(512) 628-1811
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X M4943 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd
Suite #200
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd
Suite #200
Austin, TX 78723-3077
Phone (512) 628-1932

Other identifiers 2

IdentifierTypeStateIssuer
M4943OtherTXMEDICAL LICENSE
286452201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KY, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20111026000700 TX Practitioner - Pediatric MedicinePractitioner - Gastroenterology 0446423040 Reassigns benefits to 1 organization
I20240104002506 KY Practitioner - Pediatric Medicine 0446423040 Reassigns benefits to 1 organization
I20260121003421 MI Practitioner - Pediatric MedicinePractitioner - Other (Physician) 0446423040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2551

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group Pediatric Gastroenterology CurrentSince Aug 14, 2011 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2026 Accepting new patients
Dell Children'S Medical Group CurrentSince Aug 14, 2011 Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Dell Children'S Medical Group Pediatric Gastroenterology Current Accepting new patients
Spectrum Health Primary Care Partners Pediatric Gastroenterology CurrentSince Jan 1, 2026 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: anees.siddiqui.1@8363.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1447462940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE #200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1932",
            "fax_number": "512-628-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE #200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1810",
            "fax_number": "512-628-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ANEES",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "M4943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "M4943",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286452201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.