Aqeel Ahmed Siddiqui, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD067368L Issued in PA

Practice address

100 E Lancaster Ave Ste 130
Wynnewood, PA 19096-3453

Phone

(610) 649-1175

Fax

(610) 896-8753

NPI assigned

Oct 13, 2005

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Nephrology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kidney Care Specialists LLCGroup PAC ID 9931450079, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FKC Wynnewood Dialysis facility, Wynnewood, PA, CCN 392539
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asiddiqui11950@direct.acumenmd.com

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.

• Kidney Care Specialists LLC

  • Nephrology Physician
  • Broomall, PA
  • NPI 1962992404
  Medicare reassignment Care Compare group NPD

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

• Renal Care Group East, Inc.

  dba Renal Care Group Wynnewood

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Wynnewood, PA
  • NPI 1588768360

  Dialysis facility

  Care Compare affiliation Name & address match
• Main Line Hospitals, Inc.

  dba Paoli Hospital

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Bryn Mawr Hospital

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1649268665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 130",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-649-1175",
            "fax_number": "610-896-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 130",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-649-1175",
            "fax_number": "610-896-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AQEEL",
        "middle_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD067368L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017889600001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asiddiqui11950@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "100 E Lancaster Ave Ste 130",
            "city": "Wynnewood",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190963453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Debika Biswal Shinohara, MD
• Maximillian Shmidheiser, PSYD
• Sachin Lal Shrestha, M.D.
• Jayalakshmi Shyamalan, MD
• Cathy Si, PA-C
• Bernita Sidhu, MD
• Alexis Sieber, MD
• Jay W. Siegfried, M.D.
• Stephan Simon, PA-C
• Vidamar Simonitsch

• Nephrology Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.