NPIMap

Individual provider Active NPI

Omama Siddiqui, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Macomb, MI
National Provider Identifier
1760910327
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301501762 Issued in MI
Practice address
46591 Romeo Plank Rd Ste 107
Macomb, MI 48044-5705
Phone
(586) 226-6080
Fax
(586) 226-6421
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301501762 MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301501762 MI Primary

Addresses

Primary practice location

46591 Romeo Plank Rd Ste 107
Macomb, MI 48044-5705

Mailing address

46591 Romeo Plank Rd Ste 107
Macomb, MI 48044-5705
Phone (586) 226-6080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200626000712 MI Practitioner - EndocrinologyPractitioner - Internal Medicine 1658649546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians

Practice addresses (Care Compare)

20229 E 9 Mile Rd
Suite 200
Saint Clair Shores, MI 48080-1775
Phone (586) 267-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group CurrentSince Dec 1, 2023 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

22201 Moross Rd
Ste 50
Grosse Pointe Woods, MI 48236
Phone (313) 343-7774

46591 Romeo Plank Rd
Ste 107
Macomb, MI 48044
Phone (586) 226-6080

20229 E 9 Mile Rd
#200
Saint Clair Shores, MI 48080
Phone (586) 267-0200

Interoperability endpoints

  • Direct secure messaging: omama.siddiqui.2@8209.direct.athenahealth.com
  • Direct secure messaging: osiddiqui1151298@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

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.

Hospital & facility affiliations 7

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": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1760910327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46591 ROMEO PLANK RD STE 107",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445705",
            "telephone_number": "586-226-6080",
            "fax_number": "586-226-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46591 ROMEO PLANK RD STE 107",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445705",
            "telephone_number": "586-226-6080",
            "fax_number": "586-226-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "OMAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301501762",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301501762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

Verify at the official NPI Registry.