Organization Active NPI

Cypress Signature Gastroenterology PLLC

  • Gastroenterology Physician
  • Cypress, TX
National Provider Identifier
1922588896
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CYPRESS SIGNATURE GASTROENTEROLOGY PLLC
Practice address
27700 Northwest Fwy Ste 350
Cypress, TX 77433-7749
Phone
(346) 666-1616
Fax
(346) 666-6613
NPI assigned
Aug 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Authorized official

Name
Dr. Sameer Siddique, MDNPI 1053544130
Title
Managing Partner
Phone
(346) 666-6616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

27700 Northwest Fwy Ste 350
Cypress, TX 77433-7749

Mailing address

27700 Northwest Fwy Ste 350
Cypress, TX 77433-7749
Phone (346) 666-6616

Other practice location 1

21212 Northwest Fwy Ste 205
Cypress, TX 77429-5885
Phone (346) 666-6616

Other identifiers 1

IdentifierTypeStateIssuer
393569401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181105002168 TX Part B Supplier - Clinic/Group Practice 8527311752 Receives reassigned benefits from 3 practitioners
Practice locations: Cypress, TX; Katy, TX

National Provider Directory

National Provider Directory

Locations

410 W Grand Pkwy S
Ste B
Katy, TX 77494
Phone (346) 666-6616

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEDFBD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1922588896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27700 NORTHWEST FWY STE 350",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774337749",
            "telephone_number": "346-666-6616",
            "fax_number": "832-220-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27700 NORTHWEST FWY STE 350",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774337749",
            "telephone_number": "346-666-1616",
            "fax_number": "346-666-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21212 Northwest Fwy Ste 205",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "TX",
            "postal_code": "774295885",
            "country_code": "US",
            "telephone_number": "346-666-6616",
            "fax_number": "832-220-6768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CYPRESS SIGNATURE GASTROENTEROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUE",
        "authorized_official_first_name": "SAMEER",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "346-666-6616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393569401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.