Organization Active NPI

Peachtree Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Roswell, GA
National Provider Identifier
1477381648
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
PEACHTREE ENDOCRINOLOGY
Practice address
11660 Alpharetta Hwy Ste 600
Roswell, GA 30076-3891
Phone
(470) 913-7350
NPI assigned
Jul 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Dr. Muhammad Faisal Khan Siddiqui, MDNPI 1740578665
Title
Practice Owner/Endocrinologist
Phone
(470) 913-7350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

11660 Alpharetta Hwy Ste 600
Roswell, GA 30076-3891

Mailing address

307 Peppermill LN
Woodstock, GA 30188-3111
Phone (470) 913-7350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241118000927 GA Part B Supplier - Clinic/Group Practice 9830623586 Receives reassigned benefits from 1 practitioner
Practice locations: Roswell, GA

National Provider Directory

National Provider Directory

Locations

11660 Alpharetta Hwy
Ste 600
Roswell, GA 30076
Phone (203) 606-3204

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1477381648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 PEPPERMILL LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883111",
            "telephone_number": "470-913-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 600",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763891",
            "telephone_number": "470-913-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-21",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "MUHAMMAD FAISAL",
        "authorized_official_middle_name": "KHAN",
        "authorized_official_title_or_position": "PRACTICE OWNER/ENDOCRINOLOGIST",
        "authorized_official_telephone_number": "470-913-7350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.