Individual provider Active NPI

Ibrahim H Sidiqi, MD

  • Interventional Cardiology Physician
  • Phoenix, AZ
National Provider Identifier
1649470071
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
50640 Issued in AZ
Practice address
3805 E Bell Rd
Suite 3100
Phoenix, AZ 85032-2105
Phone
(602) 867-8644
Fax
(602) 795-5698
NPI assigned
Jul 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 50640 AZ Primary
Internal Medicine Physician 207R00000X 4301084825 MI

Addresses

Primary practice location

3805 E Bell Rd
Suite 3100
Phoenix, AZ 85032-2105

Mailing address

3805 E Bell Rd Ste 3100
Phoenix, AZ 85032-2136
Phone (602) 494-3656

Other identifiers 1

IdentifierTypeStateIssuer
037987MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921002666 AZ Practitioner - Interventional Cardiology 8022200112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiovascular Consultants LTDGroup PAC ID 3577551084, 21 clinicians
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

19646 N 27TH Ave
Suite 408
Phoenix, AZ 85027-4028
Phone (602) 867-8644

7373 N Scottsdale Rd
Suite B120
Scottsdale, AZ 85253-3555
Phone (480) 718-5072

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting22
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301084825MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Consultants LTD CurrentSince Sep 1, 2015 Accepting new patients
Lake Havasu Primary Care PLLC Internal Medicine CurrentSince May 1, 2020 Accepting new patients
Cardiovascular Consultants LTD Current Accepting new patients
Honorhealth Ambulatory Cardiovascular Disease Past Accepting new patients

Locations

3624 W Anthem Way
Ste C100
Anthem, AZ 85086
Phone (623) 312-3000

36889 N Tom Darlington Dr
Carefree, AZ 85377
Phone (480) 488-9220

13620 N Saguaro Blvd
Ste 50
Fountain Hls, AZ 85268
Phone (480) 837-6800

5422 W Thunderbird Rd
Ste 8
Glendale, AZ 85306
Phone (602) 583-5800

16222 N 59th Ave
Ste A100
Glendale, AZ 85306
Phone 62333440007036

5620 W Thunderbird Rd
Ste D3
Glendale, AZ 85306
Phone (602) 562-9800

18700 N 64th Dr
Ste 101
Glendale, AZ 85308
Phone (623) 561-6211

1325 N Litchfield Rd
Ste 130
Goodyear, AZ 85395
Phone (602) 249-8577

89 Civic Center Ln
Lake Havasu City, AZ 86403
Phone (928) 453-0777

14155 N 83rd Ave
Ste 136
Peoria, AZ 85381
Phone (623) 847-3884

19646 N 27th Ave
Phoenix, AZ 85027
Phone (602) 663-9371

3805 E Bell Rd
Ste 3100
Phoenix, AZ 85032
Phone (602) 494-3656

6036 N 19th Ave
Ste 312
Phoenix, AZ 85015
Phone (602) 246-5570

9100 N 2nd St
Ste 321
Phoenix, AZ 85020

19646 N 27th Ave
Ste 408
Phoenix, AZ 85027
Phone (480) 718-5072

20565 N 19th Ave
Phoenix, AZ 85027
Phone 61064489002831

3501 N Scottsdale Rd
Ste 348
Scottsdale, AZ 85251
Phone (480) 874-0771

7970 E Thompson Peak Pkwy
Ste 101
Scottsdale, AZ 85255
Phone (480) 419-9033

8575 E Princess Dr
Ste 115
Scottsdale, AZ 85255
Phone (480) 538-1355

10210 N 92nd St
Ste 301
Scottsdale, AZ 85258
Phone (480) 391-0555

10440 E Riggs Rd
Ste 200
Sun Lakes, AZ 85248
Phone (480) 814-0266

Interoperability endpoints

  • Direct secure messaging: ibrahimsidiqi@cvc.allscriptsdirect.net
  • Direct secure messaging: ibrahim.sidiqi.1@31664.direct.athenahealth.com

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 6

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": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1649470071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 E BELL RD STE 3100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322136",
            "telephone_number": "602-494-3656",
            "fax_number": "602-867-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 E BELL RD",
            "address_2": "SUITE 3100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322105",
            "telephone_number": "602-867-8644",
            "fax_number": "602-795-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDIQI",
        "first_name": "IBRAHIM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "50640",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301084825",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037987",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.