Jamal Dean Siddiqui, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

LP02002 Issued in RI

Practice address

7171 S Yale Ave Ste 103
Tulsa, OK 74136-6367

Phone

(918) 747-3937

Fax

(918) 748-8707

NPI assigned

Jun 3, 2010

Last updated

Oct 27, 2020By the provider in NPPES

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 OK

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

Ophthalmology

Education

University of Oklahoma College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Eye Institute IncGroup PAC ID 7911995337, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Health Ponca City Hospital, Ponca City, OK, CCN 370006

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: js@eyeinstitute.ecldirect.net
• Direct secure messaging: jsiddiqui@teiok.intellechartdirect.net

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.

• The Eye Institute Inc

  • Ophthalmology Physician
  • Tulsa, OK
  • NPI 1982638516
  Medicare reassignment Care Compare group NPD
• Integris Health Ponca City Hospital Inc

  dba Integris Health Ponca City Hospital

  • General Acute Care Hospital
  • Ponca City, OK
  • NPI 1548047616
  NPD (past)
• Marc a Goldberg MD PC

  dba Marc A Goldberg MD Optical

  • Eyewear Supplier
  • Tulsa, OK
  • NPI 1174836241
  NPD (past)
• South Tulsa Optical, Inc.

  • Eyewear Supplier
  • Tulsa, OK
  • NPI 1891896932
  NPD (past)

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

• Integris Health Ponca City Hospital Inc

  dba Integris Health Ponca City Hospital

  • General Acute Care Hospital
  • Ponca City, OK
  • NPI 1548047616
  Care Compare affiliation

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1578883336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 500",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045642",
            "telephone_number": "918-747-3937",
            "fax_number": "918-748-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 S YALE AVE STE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366367",
            "telephone_number": "918-747-3937",
            "fax_number": "918-748-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "JAMAL",
        "middle_name": "DEAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "LP02002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W. Sibley Jr., D.C.
• Raymee E Sickler, DO
• Ashlyn Sidders
• Alysha Siddiqi
• Aimen Siddique, MD
• Neha Siddiqui, MD
• Kimberly Denise Sides, BSN
• Sherry Sides, APRN FNP-C
• Rajvir Sidhu
• June L Siebert, LPC

• Ophthalmology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Ophthalmology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.