NPIMap

Individual provider Active NPI

Ishreth Fatima Siddiqui, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1710113659
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1294 Issued in TX
Practice address
701 S Zarzamora St
San Antonio, TX 78207-5209
Phone
(210) 358-7474
Fax
(210) 358-7406
NPI assigned
Jun 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R1294 TX Primary

Addresses

Primary practice location

701 S Zarzamora St
San Antonio, TX 78207-5209

Mailing address

PO Box 87
San Antonio, TX 78291-0087
Phone (210) 358-9172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, PA2 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
I20170202002129 TX Practitioner - Family Practice 5799941563 Reassigns benefits to 2 organizations
I20191105003138 PA Practitioner - HospitalistPractitioner - Family Practice 5799941563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

1801 N Loop W
Suite 30
Houston, TX 77008-1445
Phone (713) 802-9781

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

9250 Pinecroft Dr
Shenandoah, TX 77380-3218
Phone (713) 897-2307

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1294TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group of Pennsylvania PC CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hermann Medical Group Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince Oct 1, 2019 Accepting new patients
Pain Management Specialists PastSince Feb 7, 2021 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

Organizations & group practices 6

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1710113659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9172",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S ZARZAMORA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075209",
            "telephone_number": "210-358-7474",
            "fax_number": "210-358-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ISHRETH",
        "middle_name": "FATIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.