Individual provider Active NPI

Mohammed Siddique Simjee, MD

  • Psychiatry Physician
  • Hartford, CT
National Provider Identifier
1235205444
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
039134 Issued in CT
Practice address
500 Vine Street
Capitol Region Mental Health Center Human Resources
Hartford, CT 06112
Phone
(860) 297-0905
Fax
(860) 297-0914
NPI assigned
Nov 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 039134 CT Primary

Addresses

Primary practice location

500 Vine Street
Capitol Region Mental Health Center Human Resources
Hartford, CT 06112

Mailing address

500 Vine Street
Capitol Region Mental Health Center Human Resources
Hartford, CT 06112
Phone (860) 297-0905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20110404000020 CT Practitioner - Psychiatry 7911181755 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, shared by 11 NPIs, 267 clinicians

Practice addresses (Care Compare)

1000 Silver St
Middletown, CT 06457-3940

500 Vine St
Hartford, CT 06112-1639
Phone (860) 297-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039134CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jan 1, 2002 Accepting new patients
State of Connecticut CurrentSince Oct 21, 2021 Accepting new patients
State of Connecticut CurrentSince Dec 19, 2016 Accepting new patients
State of Connecticut CurrentSince Jan 1, 2002 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

500 Vine St
Hartford, CT 06112
Phone (860) 293-6400

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235205444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VINE STREET",
            "address_2": "CAPITOL REGION MENTAL HEALTH CENTER HUMAN RESOURCES",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06112",
            "telephone_number": "860-297-0905",
            "fax_number": "860-297-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VINE STREET",
            "address_2": "CAPITOL REGION MENTAL HEALTH CENTER HUMAN RESOURCES",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06112",
            "telephone_number": "860-297-0905",
            "fax_number": "860-297-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMJEE",
        "first_name": "MOHAMMED",
        "middle_name": "SIDDIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "039134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.