Albert K.Q. Siu, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

C42209 Issued in CA

Practice address

2625 Coffee Rd
Ste S
Modesto, CA 95355-2050

Phone

(209) 577-1200

Fax

(209) 577-6517

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 11

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Delta Pathology Associates Medical Group Inc

  • Clinical Medical Laboratory
  • Stockton, CA
  • NPI 1306814918

  Blood Banking & Transfusion Medicine

  NPD Authorized official
• Yosemite Pathology Medical Group

  • Clinical Medical Laboratory
  • Modesto, CA
  • NPI 1831364140
  NPD (past)
• Yosemite Pathology Medical Group, in

  • Clinical Medical Laboratory
  • Tracy, CA
  • NPI 1114192176
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1710955364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 COFFEE RD",
            "address_2": "STE S",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552050",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 COFFEE RD",
            "address_2": "STE S",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552050",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIU",
        "first_name": "ALBERT",
        "middle_name": "K.Q.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C42209",
            "primary": true
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZP0104X",
            "taxonomy_group": "",
            "desc": "Pathology, Chemical Pathology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "CA",
            "license": "C42209",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NO",
            "identifier": "220020692",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BO964",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB09388F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobby Siphavong
• Azalea Sirl
• Darin Sise, 43429
• Tracy Sise, COSA
• Paulo Sitagata, PT, DPT, FAFS
• Rajaratnam Skantharaja, MD
• Lyndsay Skeen
• Marek Tadeusz Skowron, M.D.
• Sky Park Health Care Inc.
• Sabrina Slater

• Anatomic Pathology & Clinical Pathology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.