Individual provider Active NPI

Shakaib Qureshi, MD

  • Neurology Physician
  • Hartford, CT
National Provider Identifier
1982126512
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
69440 Issued in CT
Practice address
1000 Asylum Ave Ste 2112
Hartford, CT 06105-1719
Phone
(860) 522-3711
NPI assigned
Jul 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301113084 MI
Neurology Physician 2084N0400X 69440 CT Primary

Addresses

Primary practice location

1000 Asylum Ave Ste 2112
Hartford, CT 06105-1719

Mailing address

1000 Asylum Ave Ste 2112
Hartford, CT 06105-1719
Phone (860) 522-3711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220512001962 CT Practitioner - Neurology 8325319775 Reassigns benefits to 1 organization
I20220603000192 MA Practitioner - Neurology 8325319775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Inpatient Medical Associates IncGroup PAC ID 7416846977, 59 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

271 Carew St
Springfield, MA 01104-2377
Phone (413) 748-9321

Hospital & facility affiliations

  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066
  • Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69440CTMDNeurology Physician
4301113084MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 1, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jun 1, 2022 Accepting new patients
Mercy Inpatient Medical Associates Inc. CurrentSince Jul 5, 2022 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

1000 Asylum Ave
Ste 2112
Hartford, CT 06105
Phone (860) 714-4749

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

233 Carew St
#101
Springfield, MA 01104
Phone (413) 748-9212

Interoperability endpoints

  • Direct secure messaging: squreshi43237@direct.trinity-health.org

Organizations & group practices 3

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 8

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1982126512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE STE 2112",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051719",
            "telephone_number": "860-522-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE STE 2112",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051719",
            "telephone_number": "860-522-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "SHAKAIB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-14",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301113084",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "69440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.