Individual provider Active NPI

Rehan Ahmad Farooqui, MD

  • Psychiatry Physician
  • Melbourne, FL
National Provider Identifier
1639393259
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME0098067 Issued in FL
Practice address
400 E Sheridan Rd
Melbourne, FL 32901-3184
Phone
(321) 722-5200
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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 ME0098067 FL Primary

Addresses

Primary practice location

400 E Sheridan Rd
Melbourne, FL 32901-3184

Mailing address

400 E Sheridan Rd
Melbourne, FL 32901-3184
Phone (321) 722-5200

Other practice location 1

1770 Cedar St
Rockledge, FL 32955-3133
Phone (321) 634-6257

Other practice location 2

2020 Commerce Dr
West Melbourne, FL 32904
Phone (321) 952-6020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070928000704 FL Practitioner - Psychiatry 2264527621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Circles of Care Inc 26 clinicians
Adult and Child Counseling and Psychiatric Center, P.a 13 clinicians

Practice addresses (Care Compare)

400 E Sheridan Rd
Melbourne, FL 32901-3122
Phone (321) 722-5200

5545 N Wickham Rd
Suite 110
Melbourne, FL 32940-7323
Phone (321) 779-9838

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0098067FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Circles of Care, Inc. CurrentSince Mar 29, 2021 Accepting new patients

Locations

400 Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5273

1770 Cedar St
Rockledge, FL 32955
Phone (321) 634-6257

2020 Commerce Dr
West Melbourne, FL 32904
Phone (321) 952-6000

Organizations & group practices 3

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1639393259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013184",
            "telephone_number": "321-722-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013184",
            "telephone_number": "321-722-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1770 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329553133",
            "country_code": "US",
            "telephone_number": "321-634-6257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "West Melbourne",
            "state": "FL",
            "postal_code": "32904",
            "country_code": "US",
            "telephone_number": "321-952-6020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAROOQUI",
        "first_name": "REHAN",
        "middle_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0098067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.