Individual provider Active NPI

Sidiki Dabo, MD

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1790073476
Registry record updated Dec 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
264823 Issued in NY
Practice address
600 E 233Rd St
Bronx, NY 10466-2604
Phone
(718) 920-9826
NPI assigned
Jul 15, 2011
Last updated
Dec 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 264823 NY Primary
Geriatric Psychiatry Physician 2084P0805X 264823 NY

Addresses

Primary practice location

600 E 233Rd St
Bronx, NY 10466-2604

Mailing address

600 E 233Rd St
Bronx, NY 10466-2604
Phone (718) 920-9826

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120807000372 NY Practitioner - PsychiatryPractitioner - NeurologyPractitioner - Geriatric Psychiatry 6800042888 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry, Neurology
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264823NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Psychiatry CurrentSince Jun 22, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Jun 22, 2012 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Jan 1, 2020 Accepting new patients
Interfaith Psychiatry Services, P.C. Psychiatry CurrentSince Mar 1, 2016 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Feb 20, 2015 Accepting new patients
Wingspan Psychiatric, LLC Psychiatry PastSince Jun 1, 2012 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

Networks

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388188800000",
    "number": "1790073476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662604",
            "telephone_number": "718-920-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABO",
        "first_name": "SIDIKI",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2013-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "264823",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "264823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.