Individual provider Active NPI

Khalid R Siddiqui, MD

  • Radiation Oncology Physician
  • Sandusky, OH
National Provider Identifier
1497753610
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
35048385S Issued in OH
Practice address
1101 Decatur St
Sandusky, OH 44870-3335
Phone
(419) 625-6647
NPI assigned
Jul 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 35048385S OH Primary

Addresses

Primary practice location

1101 Decatur St
Sandusky, OH 44870-3335

Mailing address

1101 Decatur St
Sandusky, OH 44870-3335
Phone (419) 625-6647

Other identifiers 1

IdentifierTypeStateIssuer
0730758MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35048385SOHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Northcoast Radiotherapy Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
North Ohio Heart Center Inc Past Accepting new patients
Holzer Clinic, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ksiddiqui161539@direct.ccf.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497753610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 DECATUR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703335",
            "telephone_number": "419-625-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DECATUR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703335",
            "telephone_number": "419-625-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "KHALID",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "35048385S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0730758",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.