Shehzad Hassan Siddique

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01084995A Issued in IN

Practice address

3620 W White River Blvd
Muncie, IN 47304-4286

Phone

(765) 288-1928

NPI assigned

Apr 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Psychiatry

Education

Pennsylvania State University College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Ball Memorial Hospital Hospital, Muncie, IN, CCN 150089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssiddique217487@wellspan.direct-ci.com
• Direct secure messaging: shehzad.siddique.p1@direct.meridianhs.nextgenshare.com

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.

• Meridian Health Services Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muncie, IN
  • NPI 1992755490
  Medicare reassignment Care Compare group NPD
• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Montpelier, IN
  • NPI 1417838574
  NPD
• Meridian Health Services Corp

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1346785037
  NPD (past)
• Meridian Health Services Corp

  • Federally Qualified Health Center (FQHC)
  • Richmond, IN
  • NPI 1578194049
  NPD (past)
• Meridian Health Services Corp

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1720347305
  NPD (past)
• Meridian Health Services Corp

  • Federally Qualified Health Center (FQHC)
  • Anderson, IN
  • NPI 1841756749
  NPD (past)
• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
  • NPI 1316573413
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  Care Compare affiliation

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1164955936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044286",
            "telephone_number": "765-288-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "SHEHZAD",
        "middle_name": "HASSAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01084995A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anson Douglas Shull
• Nicole Marie Shull
• Zachary Julian Card Shumaker, MD
• Catherine N Shumate, LMHC
• Jennifer Sickels, OT
• Elizabeth Siegle
• Damien Ange Sighaka Sighaka, MD
• Signal Health Group Inc
• Bobbi Jo Silva, MSW, LSW
• Saroj Silwal, MD

• Psychiatry Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.