Individual provider Active NPI

Sameer Siddiqui, M.D.

  • Spinal Cord Injury Medicine Physician
  • Cleveland, OH
National Provider Identifier
1508271586
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X
License
274909 Issued in MA
Practice address
10701 East Blvd, 128 (W)
Cleveland, OH 44106
Phone
(216) 791-3800
NPI assigned
Jun 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Spinal Cord Injury Medicine Physician 2081P0004X 274909 MA Primary

Addresses

Primary practice location

10701 East Blvd, 128 (W)
Cleveland, OH 44106

Mailing address

10701 East Blvd, 128 (W)
Cleveland, OH 44106
Phone (216) 791-3800

Other practice location 1

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 515-0492

Other practice location 2

300 1st Ave
Charlestown, MA 02129-3109
Phone (617) 952-5243

Other practice location 3

1400 Vfw Pkwy
West Roxbury, MA 02132-4927
Phone (857) 203-5128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274909MAMDSpinal Cord Injury Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1508271586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD, 128 (W)",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-791-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD, 128 (W)",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-791-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 W Chambers St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532101650",
            "country_code": "US",
            "telephone_number": "414-515-0492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "MA",
            "postal_code": "021293109",
            "country_code": "US",
            "telephone_number": "617-952-5243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Vfw Pkwy",
            "address_purpose": "LOCATION",
            "city": "West Roxbury",
            "state": "MA",
            "postal_code": "021324927",
            "country_code": "US",
            "telephone_number": "857-203-5128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SAMEER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "MA",
            "license": "274909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.