Mohamed Siddique, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301047009 Issued in MI

Practice address

9315 Telegraph
Redford, MI 48239

Phone

(313) 450-4500

Fax

(313) 450-4514

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lincoln Behavioral Services

  • Psychiatry Physician
  • Redford, MI
  • NPI 1669451944
  Medicare reassignment NPD
• Southwest Counseling Solutions

  dba Southwest Conseling Services

  • Psychiatry Physician
  • Detroit, MI
  • NPI 1386756153
  Medicare reassignment NPD
• Victor M. Cruz MD, P.C.

  dba Cruz Clinic

  • Psychiatry Physician
  • Livonia, MI
  • NPI 1023036514
  Medicare reassignment NPD
• Lincoln Behavioral Services

  • Family Medicine Physician
  • Redford, MI
  • NPI 1356987762
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114086857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6286 TIMBERWOOD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48322",
            "telephone_number": "313-661-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 TELEGRAPH",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "48239",
            "telephone_number": "313-450-4500",
            "fax_number": "313-450-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301047009",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301047009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffani Shebli
• Susan Shelley
• Hyun Shin, M.D.
• Shayla Shuck
• Jennifer L Sibert
• Randhir Sidhu, MA RSST
• Ami Sikes, LMSW
• Sandrea Simmons
• Tamika Simmons
• Simple-Ride Transportation

• Psychiatry Physician in Redford, MI
• Providers in Redford, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.