Individual provider Active NPI

Atif Inam Siddiqi, RPA-C

  • Physician Assistant
  • Freehold, NJ
National Provider Identifier
1649403619
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013485 Issued in NY
Practice address
16 Chambry Court
Freehold, NJ 07728
Phone
(732) 637-8003
NPI assigned
Aug 25, 2009
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00226500 NJ
Physician Assistant 363A00000X 013485 NY Primary

Addresses

Primary practice location

16 Chambry Court
Freehold, NJ 07728

Mailing address

1 Hamilton Health PL
Hamilton, NJ 08690-3542
Phone (609) 584-6666

Other identifiers 1

IdentifierTypeStateIssuer
03230917MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111027000368 NJ Practitioner - Physician Assistant 1153469275 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

1 Hamilton Health PL
Hamilton, NJ 08690-3542
Phone (609) 586-7900

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (908) 994-5422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013485NYMDPhysician Assistant

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1649403619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HAMILTON HEALTH PL",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086903542",
            "telephone_number": "609-584-6666",
            "fax_number": "609-584-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CHAMBRY COURT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-637-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "ATIF",
        "middle_name": "INAM",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2024-04-25",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00226500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03230917",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.