Individual provider Active NPI

Rehan Siddiqui, M.D.

  • Psychiatry Physician
  • Elizabeth, NJ
National Provider Identifier
1871736397
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA09629100 Issued in NJ
Practice address
655 E Jersey St
Psychiatry Residency Program
Elizabeth, NJ 07206-1259
Phone
(908) 904-7503
NPI assigned
Apr 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA09629100 NJ Primary

Addresses

Primary practice location

655 E Jersey St
Psychiatry Residency Program
Elizabeth, NJ 07206-1259

Mailing address

655 E Jersey St
Psychiatry Residency Program
Elizabeth, NJ 07206-1259
Phone (908) 904-7503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20161004002915 NJ Practitioner - Psychiatry 9931497112 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group, PCGroup PAC ID 0648172809, 257 clinicians

Practice addresses (Care Compare)

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09629100NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Jersey Omb Centralized Payroll CurrentSince Mar 15, 2019 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Mar 15, 2019 Accepting new patients
Barnabas Health Medical Group, PC CurrentSince Jul 26, 2016 Accepting new patients
Princeton House Provider Group LLC Psychiatry CurrentSince Feb 1, 2018 Accepting new patients
Clara Maass Medical Center Past Accepting new patients
Clara Maass Medical Center Past Accepting new patients
Princeton Healthcare System, a New Jersey Non-Profit Corporation Past Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

993 Lenox Dr
Ste 207
Lawrenceville, NJ 08648

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

1460 Livingston Ave
Bldg 100
North Brunswick, NJ 08902
Phone (732) 729-3600

905 Herrontown Rd
Princeton, NJ 08540
Phone (609) 497-3300

266 King George Rd
Warren, NJ 07059
Phone (732) 667-7778

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1871736397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "address_2": "PSYCHIATRY RESIDENCY PROGRAM",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061259",
            "telephone_number": "908-904-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E JERSEY ST",
            "address_2": "PSYCHIATRY RESIDENCY PROGRAM",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072061259",
            "telephone_number": "908-904-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "REHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09629100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.