Individual provider Active NPI

Amar Siddique, M.D.

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1659359404
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A93835 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 703-3050
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125-047116 IL
Neonatal-Perinatal Medicine Physician 2080N0001X A93835 CA
Pediatrics Physician 208000000X A93835 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

4400 Truxel Rd
Apt # 127
Sacramento, CA 95834-3708
Phone (916) 762-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-047116ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amar Siddique MD Inc Pediatrics Current Accepting new patients
Valley Children'S Specialty Medical Group, Inc. Pediatrics Past Accepting new patients
Community Foundation Medical Group Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

726 N Medical Center Dr E
Ste 205
Clovis, CA 93611
Phone (559) 859-3536

4910 E Ashlan Ave
Ste 116
Fresno, CA 93726
Phone (559) 228-2990

7235 N 1st St
Ste 103
Fresno, CA 93720
Phone (559) 432-2600

5606 E Kings Canyon Rd
Fresno, CA 93727

1521 N Schnoor Ave
Ste 103
Madera, CA 93637

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1659359404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 TRUXEL RD",
            "address_2": "APT # 127",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958343708",
            "telephone_number": "916-762-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-703-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "AMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-047116",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A93835",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A93835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.