Shafi Ullah Siddiqi, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A102176 Issued in CA

Practice address

31569 Canyon Estates Dr
Ste 201
Lake Elsinore, CA 92532-0475

Phone

(951) 226-0866

Fax

(951) 226-0868

NPI assigned

Dec 27, 2009

Last updated

Dec 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CA

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

Internal Medicine

Education

Un of California, Irvine, College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Shafi Siddiqi MD a Professional Corporation

  • General Practice Physician
  • Lake Elsinore, CA
  • NPI 1477229995
  Medicare reassignment NPD
• Duane Darnell D.O. a Professional Corporation

  • Internal Medicine Physician
  • Sun City, CA
  • NPI 1265855829
  NPD (past)

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

{
    "created_epoch": "1261872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1538499470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR",
            "address_2": "STE 201",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320475",
            "telephone_number": "951-226-0866",
            "fax_number": "951-226-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR",
            "address_2": "STE 201",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320475",
            "telephone_number": "951-226-0866",
            "fax_number": "951-226-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SHAFI",
        "middle_name": "ULLAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-27",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A102176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bharti Sharma
• Ann Marie Shelton-Hinojosa, MFTI
• Damien Sheppard I
• Rex K Sheppard
• Saema Sial, PA
• Regina Rae Siez, L.C.S.W.
• Betsy Silva
• Marcilla Silva
• Anita C Singh, D.D.S.
• Gurpreet Singh

• General Practice Physician in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.