MEDICARE: SAMEEN ALI SIDDIQUI MS, RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1710828157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMEEN ALI SIDDIQUI MS, RD

Provider Business Mailing Address
First Line	:	3595 W 116TH ST
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-4839
Country	:	US
Telephone Number	:	317-656-9515
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	04/01/2026

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