{"npi":"1477533396","type":"NPI-1","status":"active","name":{"display":"Dr. Pervez Siddiqui MD","other":[],"first":"PERVEZ","last":"SIDDIQUI","middle":"A","credential":"MD"},"specialty":{"primary_taxonomy":"2085R0202X","primary_taxonomy_description":"Diagnostic Radiology","slug":"diagnostic-radiology","schema_org_specialty":"Radiography","all":[{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"FL","license":"89399"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"TX","license":"R0130"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":true,"state":"IN","license":"01082784A"},{"code":"363AM0700X","description":"Medical Physician Assistant","primary":false,"state":"FL","license":"89399"}]},"addresses":[{"purpose":"LOCATION","street_1":"9045 LA FONTANA BLVD STE 225","city":"BOCA RATON","state":"FL","postal_code":"334345643","country_code":"US","phone":"5613145377","fax":"5618923868"},{"purpose":"MAILING","street_1":"9045 LA FONTANA BLVD STE 225","city":"BOCA RATON","state":"FL","postal_code":"334345643","country_code":"US"}],"license":{"state":"IN","number":"01082784A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"268692900","state":"FL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040308000681","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"FL","pac_id":"7012805484"},{"enrlmt_id":"I20040518000816","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"NY","pac_id":"7012805484"},{"enrlmt_id":"I20141010001454","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"NJ","pac_id":"7012805484"},{"enrlmt_id":"I20160817000494","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"CA","pac_id":"7012805484"},{"enrlmt_id":"I20170207002074","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"PA","pac_id":"7012805484"},{"enrlmt_id":"I20190819000119","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"MI","pac_id":"7012805484"},{"enrlmt_id":"I20190819000204","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"IN","pac_id":"7012805484"},{"enrlmt_id":"I20190819001983","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"IL","pac_id":"7012805484"},{"enrlmt_id":"I20250328003025","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"NV","pac_id":"7012805484"}]},"enumeration_date":"2006-01-18","last_updated":"2026-01-12","_meta":{"source":"NPPES","snapshot_date":"2026-01-12","doc_url":"https://findmynpi.com/api"}}