Mason Olivia Siddiqui, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

724 Leigh Dr
Columbus, MS 39705-3098

Phone

(662) 328-3375

Fax

(662) 328-3395

NPI assigned

Aug 27, 2021

Last updated

Mar 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, AZ, MS3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethany R Hairston MDGroup PAC ID 0143359257, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.52 of 100Reported as group

Quality

66.08

Promoting interoperability

100

Improvement activities

40

Cost

58.3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msiddiqui@directaddress.net

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.

• Bethany R Hairston MD

  dba The Dermatology Clinic

  • Dermatology Physician
  • Columbus, MS
  • NPI 1982836037
  Medicare reassignment Care Compare group NPD
• City of Hope Medical Group of Arizona LLC

  • Medical Oncology Physician
  • Goodyear, AZ
  • NPI 1609026806
  Medicare reassignment
• Subei Medical PLLC

  dba Urgentology Care

  • Urgent Care Clinic/Center
  • Arlington, TX
  • NPI 1265942098
  Medicare reassignment
• Aqua Dermatology of Alabama PC

  dba Sunrise Dermatology

  • MOHS-Micrographic Surgery Physician
  • Vestavia HLS, AL
  • NPI 1477708642
  NPD

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1447927207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053098",
            "telephone_number": "662-328-3375",
            "fax_number": "662-328-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053098",
            "telephone_number": "662-328-3375",
            "fax_number": "662-328-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MASON",
        "middle_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msiddiqui@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Vitality Dermatology",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "724 Leigh Dr",
            "city": "Columbus",
            "state": "MS",
            "country_code": "US",
            "postal_code": "397053098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Denise Shields
• Kenyon Scott Shiflett
• Angela L Shine, BSW, LMSW
• David Patrick Shipp, D.M.D
• Kristi Lynn Shurden, FNPBC
• Megan Siems, PT
• Teresa Marie Sims, FNP-BC
• Patrick Holland Singley, D.M.D.
• John Woody Sistrunk Jr.
• SJBJ PLLC (Flexx Chiropractic)

• Physician Assistant in Columbus, MS
• Providers in Columbus, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.