Shawn Siddiqi

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1045938 Issued in TX

Practice address

2771 Sherman St
Grand Prairie, TX 75051-6016

Phone

(972) 647-0550

Fax

(972) 647-1010

NPI assigned

Mar 19, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• DFW Family Clinic

  • Family Medicine Physician
  • Grand Prairie, TX
  • NPI 1811228851
  Medicare reassignment NPD
• DFW Family Clinic

  • Medical Physician Assistant
  • Grand Prairie, TX
  • NPI 1962881441
  NPD (past)

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1457110546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 SHERMAN ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750516016",
            "telephone_number": "972-647-0550",
            "fax_number": "972-647-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 SHERMAN ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750516016",
            "telephone_number": "972-647-0550",
            "fax_number": "972-647-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1045938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Short, COTA
• Si Medical Equipment Services LLC
• Mannah John Siafa, RN
• Siddig Izzeldin Siddig
• Adila Nighat Siddiqi, D.O.
• Sameen Rab Siddiqui
• Luis Sierra-Nieves, P.A.C.
• Signage Health Care Services, Inc (Elder Choice Health Care Services)
• Lyvonne Greene- Simington, HCS-PROVIDER
• Jason Simmons, LVN

• Family Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.