Anum Khan Siddiqui, D.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS019663 Issued in PA

Practice address

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Phone

(484) 337-4097

Fax

(484) 337-4082

NPI assigned

May 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anum.siddiqui.1@18824.direct.athenahealth.com

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.

• Aria Health Physician Services

  dba Richboro Medical

  • Family Medicine Physician
  • Richboro, PA
  • NPI 1750949806
  Medicare reassignment Care Compare group NPD
• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Surgical Associates Holme

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361
  Medicare reassignment NPD
• Aria Health Physician Services

  dba Geoffrey W. Temple Family Medical Associates

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD
• Aria Health Physician Services - Trauma

  • Trauma Surgery Physician
  • Philadelphia, PA
  • NPI 1558497644
  NPD
• Trinity Health Mid-Atlantic Medical Group

  dba St. Mary Complete Breast Care

  • Surgery Physician
  • Langhorne, PA
  • NPI 1396286084
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175
  NPD
• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1780032037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-4097",
            "fax_number": "484-337-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Langhorne Newtown Rd Ste 226",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471224",
            "country_code": "US",
            "telephone_number": "215-710-4460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ANUM",
        "middle_name": "KHAN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS019663",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS019663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Shoumer, DMD
• Fiona Siobhan Shovlin, RN
• Abigail Joy Shreero
• Pragati Shukla, M.D.
• Amir Siadatan, MD
• Patricia Siegrist, RN
• Kara Siemer, PT, DPT
• Jedidiah Siev, PH.D.
• Deborah Marie Signorino, OD
• Laurel Moldawsky Silber, PSY.D.

• Internal Medicine Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.

Verify at the official NPI Registry.