Shahab Z Siddiqui, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

D45031 Issued in MD

Practice address

324 E Antietam St Ste 305
Hagerstown, MD 21740-5768

Phone

(301) 791-2510

Fax

(301) 739-7798

NPI assigned

Jun 20, 2006

Last updated

Oct 4, 2012By the provider in NPPES

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

Enrolled in MD

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

Internal Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Allegeny Medical LLCGroup PAC ID 2860631959, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Home Call Home health agency, Frederick, MD, CCN 217040
• Meritus Medical Center, Inc Home health agency, Hagerstown, MD, CCN 217085
• Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Allegeny Medical LLC

  • Internal Medicine Physician
  • Hagerstown, MD
  • NPI 1821370644
  Medicare reassignment Care Compare group NPD Authorized official
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Meritus Medical Center Inc

  • General Acute Care Hospital
  • Hagerstown, MD
  • NPI 1942281266
  NPD (past)
• Meritus Medical Laboratory LLC

  • Clinical Medical Laboratory
  • Hagerstown, MD
  • NPI 1679518971
  NPD (past)

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

• Homecall, LLC

  dba HomeCall

  • Home Health Agency
  • Frederick, MD
  • NPI 1790870350
  Care Compare affiliation
• Meritus Medical Center, Inc.

  dba Meritus Home Health

  • Home Health Agency
  • Hagerstown, MD
  • NPI 1942290077
  Care Compare affiliation
• Waynesboro Hospital

  dba WellSpan Waynesboro

  • Clinic/Center
  • Waynesboro, PA
  • NPI 1083780894

  Hospital

  Care Compare affiliation
• Waynesboro Hospital

  dba WellSpan Waynesboro Hospital

  • Clinic/Center
  • Fayetteville, PA
  • NPI 1306989561

  Hospital

  Care Compare affiliation
• Waynesboro Hospital

  dba WellSpan Waynesboro Hospital

  • General Acute Care Hospital
  • Waynesboro, PA
  • NPI 1821091059
  Care Compare affiliation

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1962448902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST STE 305",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405768",
            "telephone_number": "301-791-2510",
            "fax_number": "301-739-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST STE 305",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405768",
            "telephone_number": "301-791-2510",
            "fax_number": "301-739-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SHAHAB",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MD",
            "license": "D45031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Shupp, BSW,CSCAD
• Rachel Shusterman-Zimmerman, LCPC
• Mysore Shyam
• Megan Leanne Sichler
• Noor Maqsood Siddiqui, M.D.
• Sightrite Medical MD LLC
• Howard W Sill, MD, PHD
• Tania Silva, LCSWC
• Ashley Marie Simmons
• Brianna Simmons

• Sports Medicine (Family Medicine) Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Sports Medicine (Family Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.