Samuel Farhan Siddiqui, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME72476 Issued in FL

Practice address

16244 S Military TRL Ste 150
Delray Beach, FL 33484-6505

Phone

(561) 638-8872

Fax

(561) 638-8874

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2017 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Palm Beach Botox

  • Neurology Physician
  • Delray Beach, FL
  • NPI 1801303920
  NPD (past) Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1902933211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16244 S MILITARY TRL STE 150",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846505",
            "telephone_number": "561-638-8872",
            "fax_number": "561-638-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16244 S MILITARY TRL STE 150",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846505",
            "telephone_number": "561-638-8872",
            "fax_number": "561-638-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SAMUEL",
        "middle_name": "FARHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME72476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Lynn Shutt, PSY.D.
• Gabriel Shvets, DDS
• Matthew D Sibley, DC
• Vivian Siblini
• Sid Imaging Inc
• Jeffrey Edward Siegal, M.D.
• Wayne M Siegel, D.C.
• Daniel Sascha Sieger, DO
• Jose Emmanuelle Sierra Prado, DC
• Marcelo Sierra

• Neurology Physician in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.