Shafi Siddiqi MD A Professional Corporation
NPI 1477229995ActiveOrganization· General Practice· Lake Elsinore, CA
General Practice in Lake Elsinore, California, registered in NPPES in August 2021. The authorized official on file is Brigette Jackson, Credentialing Specialist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1477229995 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 17, 2021 |
| Last updated in NPPES | Aug 17, 2021 |
| Certified by provider | Aug 17, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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