Genesee Street Medical Health

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

232467 Issued in NY

Legal business name

GENESEE STREET MEDICAL HEALTH

Practice address

286 Genesee St Ste 5
Utica, NY 13502

Phone

(315) 266-0600

Fax

(315) 266-0611

NPI assigned

Nov 28, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Minhaj U Siddiqi, MDNPI 1598858458

Title

Owner/ Provider

Phone

(315) 335-4619

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Minhaj Siddiqi, MD

  • Specialist
  • Utica, NY
  • NPI 1598858458
  Medicare reassignment NPD Authorized official
• Mary Hunt-Miller, LCSW

  • Social Worker
  • Utica, NY
  • NPI 1245335298
  NPD (past)
• Cheryl Loomis, PHD

  • Clinical Psychologist
  • Utica, NY
  • NPI 1336539527
  NPD (past)
• Judith Owens-Manley, PH.D., LCSW-R

  • Clinical Social Worker
  • Sauquoit, NY
  • NPI 1003957317
  NPD (past)

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1184138265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 GENESEE ST STE 5",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024639",
            "telephone_number": "315-266-0600",
            "fax_number": "315-266-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 GENESEE ST STE 5",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-266-0600",
            "fax_number": "315-266-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE STREET MEDICAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "MINHAJ",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "315-335-4619",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "232467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04989199",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Stephen Gazitano, MSW
• Danielle Marie Gazzilli
• Satish Gedela, MD
• Genesee Anesthesia PLLC
• Genesee RX Inc
• Genoa Healthcare LLC
• Geoffrey Simon MD
• Alexandra Briana George
• Georges Akl MD PLLC
• Mary Beth Germann, RN

• Psychiatry Physician in Utica, NY
• Providers in Utica, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.