Active NPI
Joosub Yusuf Essack, M.D.
- Psychiatry Physician
- Manchester, CT
National Provider Identifier
1821048976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 016517
- Practice address
- 13 E Middle Tpke
Manchester, CT 06040-4249 - Phone
- (860) 646-6973
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 016517 | CT | Primary |
Addresses
Primary practice location
13 E Middle Tpke
Manchester, CT 06040-4249
Mailing address
13 E Middle Tpke
Manchester, CT 06040-4249
Phone (860) 646-6973
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060410000020 | CT | Practitioner - Psychiatry | 4284643941 | Practice locations: Manchester, CT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016517 | CT | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821048976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 E MIDDLE TPKE",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404249",
"telephone_number": "860-646-6973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 E MIDDLE TPKE",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404249",
"telephone_number": "860-646-6973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESSACK",
"first_name": "JOOSUB",
"middle_name": "YUSUF",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "016517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.