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ISMAEEL SIDDIQI
NPI 1386103273
Internal Medicine in Cincinatti, OH

Active since March 19, 2019PECOS EnrolledAccepts Medicare Assignment
69.85/100
CMS Quality Rating
234 GOODMAN STREET ML 0781- INTERNAL MEDICINE, CINCINATTI, OH 45219(513) 584-4505(513) 584-0468 Get Directions Write a Review

NPPES record last updated: October 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 21, 2022, Mar 19, 2019 (2 updates tracked since 2019).

About Ismaeel Siddiqi NPPES

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

ISMAEEL SIDDIQI (NPI 1386103273) is an individual internal medicine provider in Cincinatti, Ohio, licensed in Kentucky (05228) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph Hospital, and is a graduate of University Of Pikeville, Kentucky College Of Osteopathic Med (2019).

NPPES Registry Identity

NPI1386103273
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameISMAEEL SIDDIQI
Location Address234 GOODMAN STREET ML 0781- INTERNAL MEDICINECincinatti, OH 45219
Mailing Address234 Goodman Street, Ml 0781Cincinnati, OH 45219-2364 · (513) 584-4505 · Fax (515) 584-0468
Phone(513) 584-4505
Fax(513) 584-0468
Sole ProprietorNo
Medical School CMSUniversity Of Pikeville, Kentucky College Of Osteopathic MedGraduated 2019
Enumeration DateMarch 19, 2019
Last NPPES UpdateOctober 21, 20222 updates tracked since enumeration
NPPES CertifiedOctober 21, 2022
✔ NPI 1386103273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 05228
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
234 GOODMAN STREET ML 0781- INTERNAL MEDICINE, Cincinatti, OH 45219
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ismaeel Siddiqi is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840525903
PECOS Enrollment IDI20221101002279
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Ismaeel Siddiqi reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospital Medicine Services Of Tennessee PC
21 mi
Hospitalist
600 WILSON CREEK RD
Lawrenceburg, IN 47025
  • Reassigned Medicare billing, Kentucky enrollment
  • 106 clinicians in this Medicare group
NPI 1528433802 (812) 537-1010
Cogent Healthcare Of Kentucky, Psc
76 mi
Internal Medicine
1 SAINT JOSEPH DR
Lexington, KY 40504
  • Reassigned Medicare billing, Kentucky enrollment
  • 236 clinicians in this Medicare group
NPI 1053362293 (859) 313-1000
24 On Physicians, PC
104 mi
Hospitalist
217 S 3RD ST
Danville, KY 40422
  • Reassigned Medicare billing, Kentucky enrollment
  • 89 clinicians in this Medicare group
NPI 1679522346 (800) 923-2247

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
240 services127 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
193 services118 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
119 services117 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
92 services40 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
54 services52 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
21 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Joseph Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180010
LocationOne Saint Joseph DriveLexington, KY 40504 · Fayette County
Emergency services

Bourbon Community Hospital

Acute Care Hospitals · Paris, KY
5/5 CMS rating
OwnershipProprietary
CMS Certification Number180046
Location9 Linville DriveParis, KY 40361 · Bourbon County
Emergency services

Georgetown Community Hospital

Acute Care Hospitals · Georgetown, KY
OwnershipProprietary
CMS Certification Number180101
Location1140 Lexington RoadGeorgetown, KY 40324 · Scott County
Emergency services Birthing friendly

Saint Joseph East

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180143
Location150 North Eagle Creek DriveLexington, KY 40509 · Fayette County
Emergency services Birthing friendly

Bluegrass Community Hospital

Critical Access Hospitals · Versailles, KY
OwnershipProprietary
CMS Certification Number181308
Location360 Amsden AvenueVersailles, KY 40383 · Woodford County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

69.85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality57.55
Cost68.12

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 Ismaeel Siddiqi's NPI number?

The NPI number for Ismaeel Siddiqi is 1386103273. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Where is Ismaeel Siddiqi located?

Ismaeel Siddiqi practices at 234 Goodman Street Ml 0781- Internal Medicine, Cincinatti, OH 45219. The listed phone number is (513) 584-4505.

What is Ismaeel Siddiqi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ismaeel Siddiqi enrolled in Medicare?

Yes. Ismaeel Siddiqi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ismaeel Siddiqi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ismaeel Siddiqi reassigns Medicare benefits to 3 organizations: Hospital Medicine Services Of Tennessee PC (Lawrenceburg, IN), Cogent Healthcare Of Kentucky, Psc (Lexington, KY) and 24 On Physicians, PC (Danville, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ismaeel Siddiqi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ismaeel Siddiqi accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter of Tennessee list Ismaeel Siddiqi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ismaeel Siddiqi affiliated with any hospitals?

According to CMS data, Ismaeel Siddiqi is affiliated with Saint Joseph Hospital, Bourbon Community Hospital, Georgetown Community Hospital, Saint Joseph East and Bluegrass Community Hospital.

When was this NPI record last updated?

The NPPES record for Ismaeel Siddiqi was last updated on October 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.