Shahida Siddiqi MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D30119 Issued in MD

Legal business name

SHAHIDA SIDDIQI MD PA

Doing business as

Eldersburg Medical Practice

Practice address

6212 Sykesville Rd
Sykesville, MD 21784-7909

Phone

(410) 549-2890

Fax

(410) 549-2891

NPI assigned

Oct 3, 2008

Last updated

Oct 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shahida Siddiqi, M.D.NPI 1780655266

Title

Physician

Phone

(410) 549-2890

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eldersburg Medical Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shahida Siddiqi, MD

  • Internal Medicine Physician
  • Sykesville, MD
  • NPI 1780655266
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1841441268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6212 SYKESVILLE RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217847909",
            "telephone_number": "410-549-2890",
            "fax_number": "410-549-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6212 SYKESVILLE RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217847909",
            "telephone_number": "410-549-2890",
            "fax_number": "410-549-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHIDA SIDDIQI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "SHAHIDA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "410-549-2890",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D30119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087570800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eldersburg Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vaishali Sheth, PHARMD
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• Natalie Simms-Granger, LMSW

• Internal Medicine Physician in Sykesville, MD
• Providers in Sykesville, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.