Individual ProviderOmer Asif SiddiquiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1325 Eastmoreland Ave Ste 445, Memphis, TN 38104-7536(901) 866-8810(901) 866-8748PECOS EnrollmentBased on the most recent information from CMS, provider Omer Asif Siddiqui is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1659577278Provider TypeIndividualFull NameAsif Siddiqui, OmerCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date6/21/2007Last Updated7/9/2025Contact InformationPractice LocationPractice Address1325 Eastmoreland Ave Ste 445, Memphis, TN 38104-7536Phone(901) 866-8810Fax(901) 302-2450Mailing LocationMailing Address1068 Cresthaven Rd Ste 300, Memphis, TN 38119-0809Phone(901) 866-8748FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RN0300XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense46512TennesseeCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense23721MississippiCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseE6551ArkansasCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense46512TennesseeProvider IdentifiersIDDescriptionIssuerID03001574DescriptionMedicaidIssuerUnlistedMississippiID1524078DescriptionMedicaidIssuerUnlistedTennesseeID187456001DescriptionMedicaidIssuerUnlistedArkansas