Individual provider Active NPI

Zehra Siddiqui, DO

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1740414028
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
266500 Issued in NY
Practice address
645 10TH Ave
New York, NY 10036-2904
Phone
(212) 265-4500
Fax
(212) 265-6565
NPI assigned
May 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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 266500 NY Primary

Addresses

Primary practice location

645 10TH Ave
New York, NY 10036-2904

Mailing address

645 10TH Ave
New York, NY 10036-2904
Phone (212) 265-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130731000081 NY Practitioner - Family Practice 2365683539 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
266500NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Urgent Care, PLLC CurrentSince Aug 30, 2016 Accepting new patients
Ryan-Chelsea Clinton Community Health Center CurrentSince Nov 6, 2017 Accepting new patients

Locations

26 Court St
Brooklyn, NY 11242
Phone (718) 283-8225

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

645 10th Ave
New York, NY 10036
Phone (212) 265-4500

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1740414028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362904",
            "telephone_number": "212-265-4500",
            "fax_number": "212-265-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100362904",
            "telephone_number": "212-265-4500",
            "fax_number": "212-265-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ZEHRA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-14",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "266500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.