Mustafa Siddique

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

4301507567 Issued in MI

Practice address

5400 Fort St Ste 200
Trenton, MI 48183-4636

Phone

(734) 362-6730

Fax

(734) 362-6735

NPI assigned

Mar 29, 2013

Sex

Male

Sole proprietor

Yes

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 MI

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

Vascular SurgeryAlso: General Surgery

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Trenton Hospital Hospital, Trenton, MI, CCN 230176
• Southeast Michigan Surgical Hospital LLC Hospital, Warren, MI, CCN 230264
• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
• Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msiddique1255891@epic00.shdirect.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment Care Compare group NPD
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
  • NPI 1114667763
  NPD
• Oakwood Ambulatory LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1003829441
  NPD (past)

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

• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Taylor, MI
  • NPI 1487605168
  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Trenton, MI
  • NPI 1740230648
  Care Compare affiliation
• Southeast Michigan Surgical Hospital, LLC

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1962402354
  Care Compare affiliation

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1487997284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 FORT ST STE 200",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834636",
            "telephone_number": "734-362-6730",
            "fax_number": "734-362-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "MUSTAFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-29",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301507567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Kathryn Sheppard, D.D.S
• Sheri L. Snider D.D.S., P.C.
• Brittany Sherwood, MD
• Madison Shivel, DO
• Miranda Shores, TLLP
• Nevaeh Simmons
• Eric Joseph Simoneaux
• Mohinder Pal Singh-Sandhu, M.D.
• Salam Ahmad Smidi, DO
• Anastasia Marie Smith, RN

• Vascular Surgery Physician in Trenton, MI
• Providers in Trenton, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.