Individual provider Active NPI

Umer Farooq, MD

  • Addiction Psychiatry Physician
  • Grand Rapids, MI
National Provider Identifier
1487885513
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
4301104367 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 455-5000
NPI assigned
Aug 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 270437 NY
Addiction Psychiatry Physician 2084P0802X 4301104367 MI Primary
Addiction Psychiatry Physician 2084P0802X 01081852A IN

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other practice location 1

790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 336-3909

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ufarooq13711@edirect.crh.org
Direct Messaging Address pcerecords.network180.x@direct.mihin.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 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
I20140729002697 MI Practitioner - Psychiatry 5092931956 Reassigns benefits to 1 organization
I20160919000327 NY Practitioner - PsychiatryPractitioner - Addiction Medicine 5092931956 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Kent County CMH AuthorityGroup PAC ID 9436314143, 63 clinicians

Practice addresses (Care Compare)

100 Patriots Rd
Stony Brook, NY 11790-3318
Phone (631) 444-8630

790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 825-5412

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.18 of 100Reported as group
Quality
75.22
Promoting interoperability
90
Improvement activities
40
Cost
90.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270437NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Jun 25, 2016 Accepting new patients
State of New York Comptrollers Office Current Accepting new patients
Kent County CMH Authority CurrentSince Apr 1, 2024 Accepting new patients
Aldad Medical PC CurrentSince Oct 1, 2020 Accepting new patients
Kent County CMH Authority CurrentSince Apr 1, 2024 Accepting new patients
Nassau Health Care Corporation CurrentSince Jun 25, 2016 Accepting new patients
State of New York Comptrollers Office CurrentSince Mar 2, 2023 Accepting new patients
Jamaica Psychiatric Services, PC CurrentSince Jul 1, 2022 Accepting new patients
State of New York Comptrollers Office CurrentSince Mar 2, 2023 Accepting new patients

Locations

260 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 459-1267

790 Fuller Ave NE
Grand Rapids, MI 49503
Phone (616) 336-3765

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

300 Community Dr
Plandome, NY 11030

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

100 Patriots Rd
Stony Brook, NY 11790
Phone (631) 444-8500

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Interoperability endpoints

  • Direct secure messaging: ufarooq104861@direct.medisys.org

Organizations & group practices 9

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1487885513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Fuller Ave NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495031918",
            "country_code": "US",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAROOQ",
        "first_name": "UMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NY",
            "license": "270437",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MI",
            "license": "4301104367",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "IN",
            "license": "01081852A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ufarooq13711@edirect.crh.org",
            "affiliation": "N",
            "address_1": "2400 17th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.network180.x@direct.mihin.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "790 Fuller Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495031918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.