Individual provider Active NPI

Madiha Syed, M.D.

  • Psychiatry Physician
  • Bloomfield, NJ
National Provider Identifier
1437543907
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
U8595 Issued in TX
Practice address
21 Lackawanna PL
Bloomfield, NJ 07003-2957
Phone
(224) 600-3508
Fax
(224) 600-3508
NPI assigned
Mar 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 297200 NY
Psychiatry Physician 2084P0800X 25MA11341800 NJ
Psychiatry Physician 2084P0800X 35.136905 OH
Psychiatry Physician 2084P0800X U8595 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

21 Lackawanna PL
Bloomfield, NJ 07003-2957

Mailing address

21 Lackawanna PL Apt 541
Bloomfield, NJ 07003-2961
Phone (224) 600-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190712001495 NY Practitioner - Psychiatry 0143539981 Reassigns benefits to 3 organizations
I20240221000062 TX Practitioner - Psychiatry 0143539981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

540 Oak Centre Dr
Suite 205
San Antonio, TX 78258-4767
Phone (844) 824-8775

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11341800NJMDPsychiatry Physician
297200NYMDPsychiatry Physician
35.136905OHMDPsychiatry Physician
U8595TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Psychiatry CurrentSince Oct 18, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Oct 18, 2019 Accepting new patients
St Josephs Hospital Health Center CurrentSince Jul 1, 2019 Accepting new patients
St Joseph'S Hospital Health Center Psychiatry CurrentSince Jul 1, 2019 Accepting new patients
North Medical PC Current Accepting new patients
Progressive Behavioral Health, PLLC Psychiatry CurrentSince Feb 5, 2024 Accepting new patients
St Josephs Medical PC CurrentSince Jul 1, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

308 S Friendswood Dr
Ste 200
Friendswood, TX 77546
Phone (253) 346-0386

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

1425 Greenway Dr
Ste 360
Irving, TX 75038
Phone (317) 362-3417

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

22001 Southwest Fwy
Ste 125
Richmond, TX 77469
Phone (832) 219-3898

540 Oak Centre Dr
Ste 205
San Antonio, TX 78258
Phone (210) 705-5001

4242 Medical Dr
Ste 6300
San Antonio, TX 78229
Phone (210) 614-8400

431 E State Highway 114
Ste 140
Southlake, TX 76092
Phone (817) 751-7802

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.madihasyed@136732.advancedmd-direct.com
  • Direct secure messaging: lifestancehealth.madihasyed@148376.advancedmd-direct.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1437543907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LACKAWANNA PL APT 541",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032961",
            "telephone_number": "224-600-3508",
            "fax_number": "224-600-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LACKAWANNA PL",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032957",
            "telephone_number": "224-600-3508",
            "fax_number": "224-600-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYED",
        "first_name": "MADIHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "297200",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA11341800",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.136905",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "U8595",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.