Individual provider Active NPI

Samrah Hasan Siddiqui, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Elmsford, NY
National Provider Identifier
1760077960
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
XXXXXX Issued in NY
Practice address
555 Taxter Rd
Elmsford, NY 10523-2336
Phone
(914) 457-4130
NPI assigned
Mar 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X XXXXXX NY Primary

Addresses

Primary practice location

555 Taxter Rd
Elmsford, NY 10523-2336

Mailing address

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Other practice location 1

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (800) 636-6683

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
I20260616001884 NY Practitioner - Internal Medicine 8123590601

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Corporate Dr
Suite 100
Yonkers, NY 10701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1760077960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 TAXTER RD",
            "city": "ELMSFORD",
            "state": "NY",
            "postal_code": "105232336",
            "telephone_number": "914-457-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Bainbridge Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672404",
            "country_code": "US",
            "telephone_number": "800-636-6683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SAMRAH",
        "middle_name": "HASAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "XXXXXX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmsford, NY

Sources for this page

Verify at the official NPI Registry.