Mian A. Siddique, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

221508 Issued in NY

Practice address

451 Clarkson Ave
G-21
Brooklyn, NY 11203-2057

Phone

(718) 245-3635

Fax

(718) 245-2321

NPI assigned

Feb 20, 2006

Sex

Male

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 NY

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

Specialty

Psychiatry

Education

Other, 1973

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Interborough Developmental and Consultation Center IncGroup PAC ID 7911898192, 167 clinicians

East Point Medical PCGroup PAC ID 0749690741, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• East Point Medical PC

  • Family Medicine Physician
  • Maspeth, NY
  • NPI 1518571751

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Interborough Developmental and Consultation Center, Inc.

  dba LSA Recovery

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment Care Compare group
• Suite 69 Medical PC

  dba Mindcore

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1104634773
  NPD
• Good Health Psychiatric Services PC

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1215213806
  NPD (past)

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1760457188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 62ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195128",
            "telephone_number": "718-748-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CLARKSON AVE",
            "address_2": "G-21",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032057",
            "telephone_number": "718-245-3635",
            "fax_number": "718-245-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUE",
        "first_name": "MIAN",
        "middle_name": "A.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "221508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Siddiq, LCSW
• Asad Riaz Siddiqi, D.O.
• Dabir Siddiqi
• Husna Siddique, MD
• Maisa Siddique
• Muhammad Uzair Siddique
• Omar Siddique, MD
• Russel Siddique, NP
• Siddiqui
• Siddiqui Corporation (The Medicine Shoppe Pharmacy)

• Psychiatry Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.
• 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.