Individual provider Active NPI

Abdul Majid Siddiqui, DO

  • Family Medicine Physician
  • Merrick, NY
National Provider Identifier
1790312973
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
321626 Issued in NY
Practice address
131 Merrick Rd
Merrick, NY 11566-4542
Phone
(516) 302-8540
Fax
(516) 223-8205
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 321626 NY Primary

Addresses

Primary practice location

131 Merrick Rd
Merrick, NY 11566-4542

Mailing address

131 Merrick Rd
Merrick, NY 11566-4542
Phone (407) 414-7289

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
I20230906001718 NY Practitioner - Internal Medicine 4880057074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347

1000 N Village Ave
Rockville Center, NY 11570-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC Family Medicine CurrentSince Jul 28, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, P.C CurrentSince Jul 28, 2023 Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

131 Merrick Rd
North Merrick, NY 11566
Phone (516) 223-1515

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: asiddiqui110444@direct-chsli.net

Organizations & group practices 3

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 6

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1790312973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664542",
            "telephone_number": "407-414-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664542",
            "telephone_number": "516-302-8540",
            "fax_number": "516-223-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ABDUL",
        "middle_name": "MAJID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "321626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.