Zain Inam Siddiqui

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01090115A Issued in IN

Practice address

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Phone

(260) 672-6620

Fax

(260) 672-6639

NPI assigned

Sep 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Radiation OncologyAlso: Internal Medicine

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apogee Medical Group Indiana PCGroup PAC ID 8729155742, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018
• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

83.98

Improvement activities

40

Cost

76.51

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zsiddiqui539551@direct.parkviewexchange.com

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.

• Apogee Medical Group Indiana PC

  • Internal Medicine Physician
  • Goshen, IN
  • NPI 1093973885
  Medicare reassignment Care Compare group NPD
• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952

  Internal Medicine

  Medicare reassignment NPD
• Beacon Medical Group, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment
• Parkview Health System, Inc.

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1952411233
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
  • NPI 1477551489
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1467068502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-672-6620",
            "fax_number": "260-672-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ZAIN",
        "middle_name": "INAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.076105",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01090115A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zsiddiqui539551@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11109 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Kelsey Shutt, FNP
• Richard William Sibley, MD
• Heather Marie Sickafoose, P.A.-C
• Amy Jo Sickels, IBCLC
• Linda Sue Sickman, PH.D., CCC-SLP
• Joshua Sidener, ATC
• Preetinder Sidhu, DMD
• Hristina Siebenaler, NP
• Sara E Siefert
• Leslie Renee Siegel

• Internal Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.