Maria Karim Siddiqui

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4062 Issued in MN

Practice address

1611 County Road B W Ste 202
Roseville, MN 55113-4053

Phone

(651) 300-1112

Fax

(651) 358-2996

NPI assigned

Jan 26, 2021

Sex

Female

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Luminous Mind IncGroup PAC ID 3678816402, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Luminous Mind Inc

  • Community/Behavioral Health Agency
  • Roseville, MN
  • NPI 1588015168
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1265023907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 202",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-300-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 202",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-300-1112",
            "fax_number": "651-358-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MARIA",
        "middle_name": "KARIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Reza Shirmast, DDS
• Shoshana E. Englard MD PA
• Kirsten Shrawder
• Sneha Shukla, MD
• Fareed Siddiqui
• Sifu Health LLC
• Desiree Sigecan
• Todd Michael Sigler, PSY.D., LP, NCC
• Daniel Signorelli, PA-C
• Barbara Jean Simon

• Mental Health Counselor in Roseville, MN
• Providers in Roseville, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.
• 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.