Individual provider Active NPI

Fatima Siddiqua Ali, MD

  • Internal Medicine Physician
  • Wichita, KS
National Provider Identifier
1700028347
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04-33044 Issued in KS
Practice address
5500 E Kellogg
Wichita, KS 67218
Phone
(316) 685-2221
NPI assigned
Mar 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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 33044 KS
Internal Medicine Physician 207R00000X 04-33044 KS Primary

Addresses

Primary practice location

5500 E Kellogg
Wichita, KS 67218

Mailing address

5500 E Kellogg
Wichita, KS 67218
Phone (316) 685-2221

Other identifiers 1

IdentifierTypeStateIssuer
200606990AMedicaidKS

Other names 1

  • Dr. Fatima Siddiqua Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140708002091 KS Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9335298173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-33044KSMDInternal Medicine Physician
33044KSMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1238198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1700028347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67218",
            "telephone_number": "316-685-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67218",
            "telephone_number": "316-685-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "FATIMA",
        "middle_name": "SIDDIQUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-28",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "33044",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-33044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200606990A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FATIMA",
            "last_name": "SIDDIQUA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.