Mujeeb U Siddiqui, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2019007495 Issued in MO

Practice address

6500 Hospital Dr
Hannibal, MO 63401-6890

Phone

(573) 629-3400

Fax

(573) 629-3988

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

General Surgery

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
• Direct secure messaging: mujeebsiddiqui@hrmg.allscriptsdirect.net

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.

• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1134311392
  Medicare reassignment Care Compare group NPD
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD
• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Kirksville, MO
  • NPI 1447789300
  NPD (past)
• Hannibal Regional Healthcare System, Inc

  • Rural Acute Care Hospital
  • Hannibal, MO
  • NPI 1922042704
  NPD (past)
• Alison a Clarey DO Inc

  • Surgery Physician
  • Centerville, OH
  • NPI 1679506356
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Premier Health Specialists Inc

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD (past)

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

• Hannibal Regional Healthcare System, Inc

  • Rural Acute Care Hospital
  • Hannibal, MO
  • NPI 1922042704
  Care Compare affiliation

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1619974797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3400",
            "fax_number": "573-629-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3400",
            "fax_number": "573-629-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MUJEEB",
        "middle_name": "U",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34-008345",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2019007495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2511491",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mujeeb.siddiqui@hannibalregional.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6500 Hospital Dr",
            "city": "Hannibal",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634016890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shinn Residential Center, Inc.
• Shinn Residential Center, Inc.
• Shinn Residential Center, Inc.
• Amelia Shipman
• Kristen Lynn Shores, CCC-MA
• Jamie Leigh Silvey, RN
• Nathan William Simmons, CRNA
• Kara Lynn Sinclair, RN
• Skills Development, Inc.
• Diane Berry Slough, FNP-C

• Surgery Physician in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.