NPIMap

Individual provider Active NPI

Mohammad Siddiqui, MD

  • Family Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1982743993
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101247640 Issued in VA
Practice address
477 McLaws Cir
Ste 1
Williamsburg, VA 23185-6316
Phone
(757) 208-0005
Fax
(757) 208-0006
NPI assigned
Feb 6, 2007
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101247640 VA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2006-0308 NM

Addresses

Primary practice location

477 McLaws Cir
Ste 1
Williamsburg, VA 23185-6316

Mailing address

477 McLaws Cir
Ste 1
Williamsburg, VA 23185-6316
Phone (757) 208-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150329000001 VA Practitioner - Family Practice 6406942523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Associates of Richmond IncGroup PAC ID 4789026071, 22 clinicians

Practice addresses (Care Compare)

4500 Mary Jane Ter
Glen Allen, VA 23059-2401
Phone (703) 991-3009

5310 Twin Hickory Rd
Glen Allen, VA 23059-5783
Phone (804) 714-6291

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101247640VAMDFamily Medicine Physician
2006-0308NMMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohammad S Siddiqui MD Inc Family Medicine CurrentSince Mar 16, 2024 Accepting new patients
Geriatric Associates of Richmond Inc Geriatric Medicine CurrentSince May 2, 2024 Accepting new patients
Express Med Urgent Care Center, Inc Family Medicine PastSince May 2, 2024 Accepting new patients
906 Thompson Street Opco LLC PastSince May 1, 2025 Accepting new patients

Locations

5310 Twin Hickory Rd
Glen Allen, VA 23059
Phone (804) 360-4242

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lucy Corr VillageChesterfield, VA, CCN 495079 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 8, 2025
Feb 8, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1982743993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 MCLAWS CIR",
            "address_2": "STE 1",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856316",
            "telephone_number": "757-208-0005",
            "fax_number": "757-208-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 MCLAWS CIR",
            "address_2": "STE 1",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856316",
            "telephone_number": "757-208-0005",
            "fax_number": "757-208-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MOHAMMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101247640",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NM",
            "license": "2006-0308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.