Individual provider Active NPI

Aisha Siddiqui, M.D.

  • Obstetrics & Gynecology Physician
  • Elkhart, IN
National Provider Identifier
1972713386
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01080953A Issued in IN
Practice address
2405 W Lexington Ave
Elkhart, IN 46514-1417
Phone
(574) 524-7575
Fax
(574) 524-7576
NPI assigned
May 23, 2007
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0076679 MD
Obstetrics & Gynecology Physician 207V00000X 01080953A IN Primary
Obstetrics & Gynecology Physician 207V00000X 036121215 IL

Addresses

Primary practice location

2405 W Lexington Ave
Elkhart, IN 46514-1417

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

1215 Lawn Ave Ste 100
Elkhart, IN 46514-2450
Phone (574) 293-2893

Other practice location 2

2222 Rieth Blvd Suite 104
Goshen, IN 46526-5869
Phone (574) 875-1082

Other practice location 3

1215 Lawn Ave Ste 110
Elkhart, IN 46514-2493
Phone (574) 524-7570

Other practice location 4

1555 N Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 755-8075

Other identifiers 2

IdentifierTypeStateIssuer
036121215MedicaidIL
300020489MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asiddiqui@mybeacon.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080826000156 IL Practitioner - Obstetrics/Gynecology 8729153721 Reassigns benefits to 3 organizations
I20181119000592 IN Practitioner - Obstetrics/Gynecology 8729153721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

1215 Lawn Ave
Suite 100
Elkhart, IN 46514-2450
Phone (574) 293-2893

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036121215ILMDObstetrics & Gynecology Physician
01080953AINMDObstetrics & Gynecology Physician
D0076679MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. Obstetrics & Gynecology CurrentSince Jan 6, 2019 Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 6, 2019 Accepting new patients
Andrew a. Roth, M.D.,S.C. Obstetrics & Gynecology CurrentSince Jul 1, 2025 Accepting new patients
Bonaventure Medical Foundation, LLC CurrentSince Mar 15, 2025 Accepting new patients
Obhg Illinois SC Obstetrics & Gynecology CurrentSince Dec 31, 2024 Accepting new patients
Healthlinc, Inc CurrentSince Jun 27, 2019 Accepting new patients
Healthlinc, Inc Obstetrics & Gynecology CurrentSince Jun 27, 2019 Accepting new patients

Locations

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

500 E 22nd St
Ste A
Lombard, IL 60148
Phone (630) 620-8061

1215 Lawn Ave
Ste 100
Elkhart, IN 46514
Phone (574) 293-2893

1215 Lawn Ave
Ste 110
Elkhart, IN 46514
Phone (574) 524-7570

236 Simpson Ave
Elkhart, IN 46516
Phone (574) 293-0052

2405 W Lexington Ave
Elkhart, IN 46514
Phone (574) 295-8805

2222 Rieth Blvd
Ste 104
Goshen, IN 46526
Phone (574) 875-1082

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1972713386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141417",
            "telephone_number": "574-524-7575",
            "fax_number": "574-524-7576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lawn Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142450",
            "country_code": "US",
            "telephone_number": "574-293-2893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd Suite 104",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-875-1082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lawn Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142493",
            "country_code": "US",
            "telephone_number": "574-524-7570",
            "fax_number": "574-524-7571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1555 N Barrington Rd",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601691019",
            "country_code": "US",
            "telephone_number": "847-755-8075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AISHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0076679",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01080953A",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036121215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036121215",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300020489",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asiddiqui@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1215 Lawn Ave Ste 100",
            "city": "Elkhart",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465142450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.