Mypsychmd LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MYPSYCHMD LLC

Doing business as

Saira Saqib,MD

Practice address

6817 Southpoint Pkwy Ste 304
Jacksonville, FL 32216-6287

Phone

(904) 296-3113

Fax

(904) 372-6175

NPI assigned

Jul 30, 2021

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Saira Saqib, MDNPI 1821757071

Title

Owner/ Physician

Phone

(904) 296-3113

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Saira Saqib,MD Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Mypsychmd LLC2 organizations share this tax ID, including this one

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Saira Saqib, MD

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1821757071

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1871266213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 COUNTY ROAD 210 W # 108-177",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594058",
            "telephone_number": "904-296-3113",
            "fax_number": "904-372-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166287",
            "telephone_number": "904-296-3113",
            "fax_number": "904-372-6175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865790",
            "country_code": "US",
            "telephone_number": "904-819-5155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Health Park Blvd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320865797",
            "country_code": "US",
            "telephone_number": "904-819-4040",
            "fax_number": "904-819-4041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2220 County Road 210 W # 108-177",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322594058",
            "country_code": "US",
            "telephone_number": "904-478-9542",
            "fax_number": "904-372-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYPSYCHMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2023-03-07",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "SAQIB",
        "authorized_official_first_name": "SAIRA",
        "authorized_official_title_or_position": "OWNER/ PHYSICIAN",
        "authorized_official_telephone_number": "904-296-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF MEDICINE",
            "identifier": "ME108320",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saira Saqib,MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saira Saqib,MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.