Shuja Uddin, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036131334 Issued in IL

Practice address

750 E Adams St
Syracuse, NY 13210-2342

Phone

(315) 944-5557

NPI assigned

Feb 13, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Macneal Hospital Hospital, Berwyn, IL, CCN 140054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: suddin151850@direct.luhs.org

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.

• Loyola Medical Group LLC

  • General Practice Physician
  • Berwyn, IL
  • NPI 1376041954

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Riveredge Hospital Inc

  • Psychiatric Hospital
  • Forest Park, IL
  • NPI 1710070701

  Multi-Specialty

  Medicare reassignment NPD
• Prestige Psychiatry 1 LLC

  • Psychiatry Physician
  • Lombard, IL
  • NPI 1225775018

  Multi-Specialty

  NPD Authorized official
• Uhs of Hartgrove, Inc.

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1396012951
  Medicare reassignment
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD

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

• Gottlieb Community Health Services Corporation

  • General Acute Care Hospital
  • Berwyn, IL
  • NPI 1295710580
  Care Compare affiliation

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1871832790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "STE 407",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023472",
            "telephone_number": "708-783-7430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102342",
            "telephone_number": "315-944-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDDIN",
        "first_name": "SHUJA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-13",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036131334",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "262817",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Fitzgerald Tyndall
• Christine L Tyrrell-Baker, PSYSHOLOGIST
• Robert John Tyson III, LPN
• Spiro Tzetzis, MD
• Ruba Uddin, M.D.
• Dayna Ukwuoma, MD
• John Mathew Ulahannan, MD
• Kelly Rose Ulen, PHARM D
• Matthew Ulrich, MT-BC
• Ultra Medical Supply, Inc.

• Psychiatry Physician in Syracuse, NY
• Providers in Syracuse, 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 Mar 7, 2022; 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.