Individual provider Active NPI

Ali Siddiqui, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Muskogee, OK
National Provider Identifier
1891732665
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
14925 Issued in OK
Practice address
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone
(918) 684-2523
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 14925 OK Primary

Addresses

Primary practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Mailing address

6600 S Yale Ave Ste 1200
Tulsa, OK 74136-3361
Phone (918) 488-6045

Other practice location 1

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2725

Other practice location 2

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2725

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asiddiqui351821@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, IN2 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
I20110801000750 OK Practitioner - Pediatric MedicinePractitioner - Other (Physician) 3577732908 Reassigns benefits to 2 organizations
I20191105000799 IN Practitioner - Pediatric Medicine 3577732908 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14925OKMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Sep 11, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Oct 24, 2019 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Oct 24, 2019 Accepting new patients
Warren Clinic Inc CurrentSince Apr 1, 2017 Accepting new patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Sep 11, 2023 Accepting new patients
Northeastern Health System Past Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

7240 Shadeland Sta
Ste 300
Indianapolis, IN 46256
Phone (317) 621-6060

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

124 E Main St
Hulbert, OK 74441
Phone (918) 772-2879

2900 N Main St
Muskogee, OK 74401
Phone (918) 300-1320

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

1500 E Downing St
Ste 201
Tahlequah, OK 74464
Phone (918) 772-3390

1310 E Boone St
Tahlequah, OK 74464
Phone (918) 456-7700

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: ali.siddiqui@direct.stjohnhealthsystem.com
  • Direct secure messaging: asiddiqui351821@ecommunitydirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 7

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1891732665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361",
            "telephone_number": "918-488-6045",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-684-2523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1923 S Utica Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741046520",
            "country_code": "US",
            "telephone_number": "918-744-2725",
            "fax_number": "918-744-3374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1923 S Utica Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741046520",
            "country_code": "US",
            "telephone_number": "918-744-2725",
            "fax_number": "918-744-3374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OK",
            "license": "14925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asiddiqui351821@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7240 Shadeland Station",
            "address_2": "Suite 300",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462563944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.