Individual provider Active NPI

Mouhamed Abdoulaye Ndiaye, MD

  • Psychiatry Physician
  • Waterbury, CT
National Provider Identifier
1982917985
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
257947 Issued in NY
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(908) 451-9433
NPI assigned
Jul 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 49079 CT
Psychiatry Physician 2084P0800X 257947 NY Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

100 Jefferson SQ Apt 6J
Waterbury, CT 06706-1136

Other identifiers 1

IdentifierTypeStateIssuer
49079OtherCTCT MD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20110329000284 CT Practitioner - Psychiatry 9133302185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

Hospital & facility affiliations

  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49079CTMDPsychiatry Physician
257947NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Apr 30, 2018 Accepting new patients
Harvest Healthcare LLC Psychiatry CurrentSince Feb 1, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Psychiatry CurrentSince Apr 30, 2018 Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

100 Grand St
Ste E119
New Britain, CT 06052
Phone (860) 224-5305

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

Interoperability endpoints

  • Direct secure messaging: mouhamed.ndiaye@xdr.hhchealthdirect.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 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": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1982917985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JEFFERSON SQ APT 6J",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "908-451-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIAYE",
        "first_name": "MOUHAMED",
        "middle_name": "ABDOULAYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "49079",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "257947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MD LICENSE",
            "identifier": "49079",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.