Active NPI
Christopher Mark Tidd, M.D.
- Psychiatry Physician
- Rochester, NY
National Provider Identifier
1700324266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 220307-1
- Practice address
- 300 Crittenden Blvd
Rochester, NY 14642-0001 - Phone
- (585) 275-3569
- NPI assigned
- Feb 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 220307-1 | NY | Primary |
Addresses
Primary practice location
300 Crittenden Blvd
Rochester, NY 14642-0001
Mailing address
78 Winder Grove South
London, ONTARIO N6K4K6
CA
Phone (519) 473-5782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220307-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486252800000",
"number": "1700324266",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "78 WINDER GROVE SOUTH",
"city": "LONDON",
"state": "ONTARIO",
"postal_code": "N6K4K6",
"telephone_number": "519-473-5782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 CRITTENDEN BLVD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-275-3569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDD",
"first_name": "CHRISTOPHER",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-05",
"last_updated": "2017-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "220307-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.