Individual provider Active NPI

MD Salahuddin Siddiqui, MD

  • Hematology & Oncology Physician
  • Salisbury, MD
National Provider Identifier
1750796611
Registry record updated Sep 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
D0100713 Issued in MD
Practice address
100 E Carroll St
Salisbury, MD 21801-5422
Phone
(410) 543-7006
Fax
(410) 749-7821
NPI assigned
Jun 30, 2014
Last updated
Sep 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 01083055A IN
Hematology & Oncology Physician 207RH0003X D0100713 MD Primary

Addresses

Primary practice location

100 E Carroll St
Salisbury, MD 21801-5422

Mailing address

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 543-7006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200611000653 IN Practitioner - Hematology/Oncology 1355620147 Reassigns benefits to 1 organization
I20240821000920 MD Practitioner - Hematology/Oncology 1355620147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01083055AINMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ball Memorial Physicians, Inc. Hematology & Oncology CurrentSince Aug 3, 2020 Accepting new patients
Tidalhealth Physician Network, Inc. CurrentSince Aug 26, 2024 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Aug 26, 2024 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

3832 Solutions Ctr
Chicago, IL 60677

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

11105 Cathage Rd
Berlin, MD 21811
Phone (410) 641-9962

3304 Hayman Dr
Federalsburg, MD 21632
Phone (410) 754-2400

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726272000000",
    "number": "1750796611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7006",
            "fax_number": "410-749-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7006",
            "fax_number": "410-749-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MD SALAHUDDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2024-09-14",
        "certification_date": "2024-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01083055A",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": "D0100713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.