Individual provider Active NPI

Mahmood Islam Siddique, D.O.

  • Internal Medicine Physician
  • Lawrenceville, NJ
National Provider Identifier
1700976073
Registry record updated Nov 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB05852900 Issued in NJ
Practice address
31 E Darrah LN
Lawrenceville, NJ 08648-3763
Phone
(609) 587-9944
Fax
(609) 587-9955
NPI assigned
Oct 14, 2006
Last updated
Nov 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MB05852900 NJ
Allergy & Immunology Physician 207K00000X 25MB05852900 NJ
Internal Medicine Physician 207R00000X 25MB05852900 NJ Primary
Pulmonary Disease Physician 207RP1001X 25MB05852900 NJ
Pain Medicine Physician 208VP0000X 25MB05852900 NJ
Sleep Medicine (Internal Medicine) Physician 207RS0012X 25MB05852900 NJ

Addresses

Primary practice location

31 E Darrah LN
Lawrenceville, NJ 08648-3763

Mailing address

31 E Darrah LN
Lawrenceville, NJ 08648-3763
Phone (609) 587-9944

Other identifiers 1

IdentifierTypeStateIssuer
5548608MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070123000002 NJ Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Sleep Medicine 8628079449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease, Sleep Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31 E Darrah LN
Lawrenceville, NJ 08648-3763
Phone (609) 587-9944

Merit-based Incentive Payment System (MIPS)

Final score
91.16 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
70.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB05852900NJMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep and Wellness Medical Associates Specialist CurrentSince Jun 21, 2009 Accepting new patients

Locations

3836 Quakerbridge Rd
Ste 206
Hamilton, NJ 08619
Phone (609) 438-9181

31 E Darrah Ln
Lawrenceville, NJ 08648
Phone (609) 403-6190

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764374400000",
    "number": "1700976073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E DARRAH LN",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086483763",
            "telephone_number": "609-587-9944",
            "fax_number": "609-587-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 E DARRAH LN",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086483763",
            "telephone_number": "609-587-9944",
            "fax_number": "609-587-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "MAHMOOD",
        "middle_name": "ISLAM",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2025-11-29",
        "certification_date": "2025-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB05852900",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MB05852900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB05852900",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB05852900",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "25MB05852900",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NJ",
            "license": "25MB05852900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5548608",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.