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SI MEDICAL PRACTICE ASSOCIATE PC
NPI 1265505036
Family Medicine - Sports Medicine in Staten Island, NY

Active since November 17, 2006CLIA 33D1042225 · Waiver
1147 RICHMOND ROAD, STATEN ISLAND, NY 10304(718) 668-2340(718) 668-2523 Get Directions Write a Review

NPPES record last updated: February 25, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Si Medical Practice Associate Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SI MEDICAL PRACTICE ASSOCIATE PC (NPI 1265505036), doing business as Si Family Practice Associate, is a healthcare organization registered as a sports medicine in Staten Island, New York and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through June 21, 2027 and lists Azher Siddiqi, Owner President, as its authorized official.

NPPES Registry Identity

NPI1265505036
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameSI MEDICAL PRACTICE ASSOCIATE PC
Location Address1147 RICHMOND ROADStaten Island, NY 10304
Mailing Address1147 Richmond RoadStaten Island, NY 10304 · (718) 668-2340 · Fax (718) 668-2523
Phone(718) 668-2340
Fax(718) 668-2523
Organization SubpartNo
Authorized OfficialAzher SiddiqiOwner President · (718) 668-2340
Enumeration DateNovember 17, 2006
Last NPPES UpdateFebruary 25, 2014
✔ NPI 1265505036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
1147 RICHMOND ROAD, Staten Island, NY 10304
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Other Names 1

Former Legal Business NameSi Family Practice Associate

Other Identifiers 1

Medicare UPINH28341NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1042225

Si Medical Practice Associates PC · Staten Island, NY
Active · expires Jun 21, 2027
CLIA Number33D1042225
Laboratory TypePhysician Office
Certificate Effective DateJune 22, 2025
Certificate Expiration DateJune 21, 2027
Laboratory DirectorDr. Azher U. Siddiqi
Laboratory Phone(718) 668-2340
Laboratory LocationSi Medical Practice Associates PC1147 Richmond Road, Staten Island, NY 10304
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Si Medical Practice Associate PC's NPI number?

The NPI number for Si Medical Practice Associate PC is 1265505036. It was assigned to this organization in the NPPES registry on November 17, 2006. The provider was formerly known as Si Family Practice Associate.

Where is Si Medical Practice Associate PC located?

Si Medical Practice Associate PC is located at 1147 Richmond Road, Staten Island, NY 10304. The listed phone number is (718) 668-2340.

What is Si Medical Practice Associate PC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Does Si Medical Practice Associate PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1042225) is associated with this NPI, valid through June 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Si Medical Practice Associate PC was last updated on February 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.