Rehana Siddiqui, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME43695 Issued in FL

Practice address

1690 Dunlawton Av, Ste 120
Port Orange, FL 32127-8980

Phone

(386) 271-2273

Fax

(386) 271-2274

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

General PracticeAlso: Family Practice

Education

Other, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Town Center Medical Services LLCGroup PAC ID 1759517568, 5 clinicians

Urgent Care Center of Port Orange LLCGroup PAC ID 5890712806, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Town Center Medical Services, LLC

  dba Advanced Family Practice and Advanced Medical Center Gastroenterology

  • Family Medicine Physician
  • Port Orange, FL
  • NPI 1427498724
  Medicare reassignment Care Compare group NPD
• Urgent Care Center of Port Orange, LLC

  dba Advanced Urgent Care

  • Urgent Care Clinic/Center
  • Port Orange, FL
  • NPI 1891905378
  Medicare reassignment Care Compare group NPD
• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637
  NPD (past)
• Memorial Hospital Flagler Inc

  dba AdventHealth Palm Coast

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  NPD (past)
• Memorial Hospital Flagler Inc.

  dba AdventHealth Medical Group

  • Multi-Specialty Clinic/Center
  • Palm Coast, FL
  • NPI 1558530600

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912964040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 DUNLAWTON AV, STE 120",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278980",
            "telephone_number": "386-271-2273",
            "fax_number": "386-271-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 DUNLAWTON AV, STE 120",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278980",
            "telephone_number": "386-271-2273",
            "fax_number": "386-271-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "REHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-03-07",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME43695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046702200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Sheputis
• Ashley Sherbert, LCSW
• Wade Shiu, RPH
• Latasha Short
• Michael W Shreeve, DC
• Signature Care LLC
• Sarah Silone
• Lauren Silver, M.S.
• Arthur Silvestri
• Tiffany Simmons

• Family Medicine Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.