Individual provider Active NPI

Mihai Tiberiu Simionescu, M.D.

  • Child & Adolescent Psychiatry Physician
  • Syracuse, NY
National Provider Identifier
1912072091
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
259598 Issued in NY
Practice address
1101 Erie Blvd E
Suite 214
Syracuse, NY 13210-1148
Phone
(315) 401-7436
Fax
(315) 401-7436
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 259598 NY Primary
Psychiatry Physician 2084P0800X 259598 NY

Addresses

Primary practice location

1101 Erie Blvd E
Suite 214
Syracuse, NY 13210-1148

Mailing address

4723 Anglia St
Manlius, NY 13104-9798
Phone (315) 637-8987

Other identifiers 1

IdentifierTypeStateIssuer
00354485MedicaidNY

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
I20060310000539 NY Practitioner - Psychiatry 5799792107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Helio Health IncGroup PAC ID 4789903147, 30 clinicians

Practice addresses (Care Compare)

329 N Salina St
Suite 200
Syracuse, NY 13203-1835
Phone (315) 471-1564

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Helio Health, Inc. CurrentSince Aug 6, 2023 Accepting new patients
Liberty Resources, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Helio Health, Inc. PastSince Dec 9, 2019 Accepting new patients

Locations

329 N Salina St
Ste 200
Syracuse, NY 13203

555 E Genesee St
Syracuse, NY 13202
Phone (315) 476-7441

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1912072091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 ANGLIA ST",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049798",
            "telephone_number": "315-637-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ERIE BLVD E",
            "address_2": "SUITE 214",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101148",
            "telephone_number": "315-401-7436",
            "fax_number": "315-401-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMIONESCU",
        "first_name": "MIHAI",
        "middle_name": "TIBERIU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "259598",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "259598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354485",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.