Individual provider Active NPI

Sadaf Alnoor Siddiqui, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1962071829
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10291 Issued in TX
Practice address
4401 Martin Luther King Blvd.
Houston, TX 77204-2020
Phone
(713) 743-2020
Fax
(713) 743-0963
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10291TG TX
Optometrist 152W00000X 10291 TX Primary

Addresses

Primary practice location

4401 Martin Luther King Blvd.
Houston, TX 77204-2020

Mailing address

4401 Martin Luther King Blvd
Houston, TX 77204-2020
Phone (713) 743-2020

Other practice location 1

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

Other identifiers 2

IdentifierTypeStateIssuer
10291OtherTXSTATE LICENSING BOARD
426104201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707003472 TX Practitioner - Optometry 5294137683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10291TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC CurrentSince Aug 29, 2022 Accepting new patients
University of Houston CurrentSince Jun 23, 2021 Accepting new patients
University of Houston System CurrentSince Jun 23, 2021 Accepting new patients
University of Houston System Optometrist Current Accepting new patients

Locations

4901 Calhoun Rd
Rm 2107
Houston, TX 77204
Phone (713) 743-1921

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

4901 Calhoun Rd
Houston, TX 77204
Phone (713) 743-1921

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480

929 Gessner Rd
Ste 1450
Houston, TX 77024
Phone (713) 442-5200

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

Interoperability endpoints

  • Direct secure messaging: ssiddiqui44755@direct.kelsey-seybold.com

Organizations & group practices 4

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1962071829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MARTIN LUTHER KING BLVD.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 W Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770251669",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SADAF",
        "middle_name": "ALNOOR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10291TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSING BOARD",
            "identifier": "10291",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426104201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.