NPIMap

Individual provider Active NPI

Wajid Ali Siddiqui, MD

  • Infectious Disease Physician
  • Columbia, SC
National Provider Identifier
1669647889
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
34048 Issued in SC
Practice address
1333 Taylor St
Suite 6-F
Columbia, SC 29201-2923
Phone
(803) 296-3273
Fax
(803) 296-7061
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT186425 PA
Infectious Disease Physician 207RI0200X 34048 SC Primary

Addresses

Primary practice location

1333 Taylor St
Suite 6-F
Columbia, SC 29201-2923

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7303

Other practice location 1

1333 Taylor St
Suite 6-F
Columbia, SC 29201-2923
Phone (803) 296-3273

Other practice location 2

115 N Sumter St Ste 315
Sumter, SC 29150-4967
Phone (803) 774-9787

Other identifiers 1

IdentifierTypeStateIssuer
340483MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130904000518 GA Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345309571 Reassigns benefits to 1 organization
I20150630000232 SC Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345309571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

1333 Taylor St
Suite 6F
Columbia, SC 29201-2953
Phone (803) 296-3273

Hospital & facility affiliations

  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073
  • Kershawhealth Hospital, Camden, SC, CCN 420048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT186425PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Infectious Disease CurrentSince Aug 9, 2013 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Nov 27, 2016 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Aug 9, 2013 Accepting new patients
Prisma Health Medical Group-Midlands Internal Medicine CurrentSince Nov 27, 2016 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

1333 Taylor St
Ste 6F
Columbia, SC 29201
Phone (803) 296-3273

3 Richland Medical Park Dr
Ste 510
Columbia, SC 29203
Phone (803) 296-2726

115 N Sumter St
Ste 315
Sumter, SC 29150
Phone (803) 774-9787

Interoperability endpoints

  • Direct secure messaging: wsiddiqui384263@direct.ghs.myhfn.org

Organizations & group practices 4

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1669647889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7303",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 TAYLOR ST",
            "address_2": "SUITE 6-F",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012923",
            "telephone_number": "803-296-3273",
            "fax_number": "803-296-7061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Taylor St",
            "address_2": "Suite 6-F",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012923",
            "country_code": "US",
            "telephone_number": "803-296-3273",
            "fax_number": "803-296-7061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 N Sumter St Ste 315",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291504967",
            "country_code": "US",
            "telephone_number": "803-774-9787",
            "fax_number": "803-774-9781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "WAJID",
        "middle_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT186425",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "34048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340483",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.