SURAIYA SIDDIQUE (MD) – General Practice Physician, NPI 1295976330
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
160 GENERAL PRACTICE in MO
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Provider Addresses for SURAIYA SIDDIQUE (MD)
Westpark Drive, Leander, Oak Forest, Little Rock, Big Rock Township, Pulaski County, Arkansas, 72204, United States
#113
LITTLE ROCK, AR 722042565
Phone: (501) 603-3466
Type: Mailing
600, Main Street, Mount Vernon, Skagit County, Washington, 98273, United States
MOUNT VERNON, MO 657121004
Phone: (417) 466-4000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $53,631.
Total Amount is formed as General ($53,631) + Research ($0) + Ownership ($0) = $53,631.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: CSL Plasma Inc. ($53,631).
Total Amount
$53,631
General + Research + Ownership
Payments
12
Total payment records
General Amount
$53,631
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CSL Plasma Inc. | $53,631 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-08-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250811001702 | I | General Practice | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 72204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IN | |
| Internal Medicine | WA | |
| Internal Medicine | IA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | IL |
Reviews
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