Jawed H. Siddiqui, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R6047 Issued in MO

Practice address

11115 New Halls Ferry Rd
Suites 301-302
Florissant, MO 63033-7613

Phone

(314) 921-6200

Fax

(314) 830-0756

NPI assigned

Jul 3, 2006

Last updated

Jun 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

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 2

Specialty

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

The Health Centers PCGroup PAC ID 4981681467, 5 clinicians

JN Wellness IncGroup PAC ID 5799199410, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Bria of Godfrey Nursing home, Godfrey, IL, CCN 145656

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 30)

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.

• JN Wellness Inc

  • Physical Medicine & Rehabilitation Physician
  • Saint Louis, MO
  • NPI 1245839166
  Medicare reassignment Care Compare group NPD
• Metro Cardiovascular, Inc.

  dba Metro Health Center

  • Internal Medicine Physician
  • Florissant, MO
  • NPI 1447404991
  Medicare reassignment NPD Authorized official
• The Health Centers, P.C.

  • Adult Medicine Physician
  • Saint Charles, MO
  • NPI 1912016916
  Medicare reassignment Care Compare group NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  IL, MO

  Medicare reassignment Care Compare group NPD
• Altea Medical Missouri LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Wildwood, MO
  • NPI 1649032608
  Medicare reassignment NPD
• Clinical Medical Services LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1497132286

  IL

  Medicare reassignment NPD
• Metro Medical Institute

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1043805229
  Medicare reassignment NPD
• St Louis Medical Center Inc

  dba Sciortino St Louis Medical Center

  • General Practice Physician
  • Saint Louis, MO
  • NPI 1730576224
  Medicare reassignment NPD
• Altea Medical Illinois PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago Heights, IL
  • NPI 1447039227
  Medicare reassignment NPD
• Metro Medical North County LLC

  • Internal Medicine Physician
  • Florissant, MO
  • NPI 1306703038
  NPD Authorized official
• Metro Medical Clinic, LLC

  • Adult Medicine Physician
  • Saint Louis, MO
  • NPI 1922585389
  Authorized official Same address or phone
• Metro Medical Urgent Care

  • Specialist
  • Florissant, MO
  • NPI 1598049751
  Authorized official Same address or phone

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

• Mercy Hospitals East Communities

  dba Mercy Hospital St Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  dba Mercy St. Louis Transport Ambulance

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Bria of Godfrey LP

  • Skilled Nursing Facility
  • Godfrey, IL
  • NPI 1861122335

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1699705293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 TOPPING RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311424",
            "telephone_number": "314-984-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 NEW HALLS FERRY RD",
            "address_2": "SUITES 301-302",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630337613",
            "telephone_number": "314-921-6200",
            "fax_number": "314-830-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "JAWED",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R6047",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-056278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7040870018",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200668739",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110125678",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raj Shivaji, M.D.
• Alicia Shivers, FNP-C
• Barbara Ann Short, RN
• Aleksandr Shoykhet, FNP-C
• Sonja Sickels, PHARM D
• Michael Dorian Siebe II, L.C.S.W.
• Silent Care LLC
• Andrea Simmons
• Kecia Simmons, MA
• Abigail Simon, MS

• Internal Medicine Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.