Individual provider Active NPI

Sabrina Zainub Siddiqui, MD, MPH

  • Internal Medicine Physician
  • Keene, NH
National Provider Identifier
1821611682
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24006 Issued in NH
Practice address
580 Court St
Keene, NH 03431-1718
Phone
(603) 354-5400
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 24006 NH Primary

Addresses

Primary practice location

580 Court St
Keene, NH 03431-1718

Mailing address

PO Box 810
Hanover, NH 03755-0810

Other practice location 1

3601 4th St
Lubbock, TX 79430-0002
Phone (806) 743-6840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240624004724 NH Practitioner - Internal Medicine 8820412281 Reassigns benefits to 2 organizations
I20250919002479 NC Practitioner - Internal Medicine 8820412281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Kimel Forest Dr
Winston Salem, NC 27103-6074

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24006NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Jun 17, 2024 Accepting new patients
Cheshire Medical Center CurrentSince Jan 3, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 3, 2025 Accepting new patients

Locations

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1821611682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311718",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-6840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SABRINA",
        "middle_name": "ZAINUB",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "24006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.