Individual provider Active NPI

Yasir Siddique, DDS

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1750623179
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS040284 Issued in PA
Practice address
2675 E Cumberland St
Philadelphia, PA 19125-3727
Phone
(215) 426-7307
NPI assigned
Mar 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15297 MD
Dentist 122300000X DS040284 PA Primary

Addresses

Primary practice location

2675 E Cumberland St
Philadelphia, PA 19125-3727

Mailing address

2675 E Cumberland St
Philadelphia, PA 19125-3727
Phone (215) 426-7307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171030000415 PA Practitioner - Dentist 3577839083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15297MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Silvana Cumani DMD and Associates PC CurrentSince Aug 15, 2017 Accepting new patients

Locations

2200 Montrose St
Philadelphia, PA 19146
Phone (215) 545-4395

2675 E Cumberland St
Philadelphia, PA 19125
Phone (215) 426-7307

Organizations & group practices 1

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": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1750623179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 E CUMBERLAND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253727",
            "telephone_number": "215-426-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 E CUMBERLAND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253727",
            "telephone_number": "215-426-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "YASIR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-24",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15297",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.