Active NPI
Samrah Hasan Siddiqui, MD
- Endocrinology, Diabetes & Metabolism Physician
- Elmsford, NY
National Provider Identifier
1760077960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- XXXXXX
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.