Individual provider Active NPI

Rodwan Mahfouz, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1073827135
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
272478 Issued in NY
Practice address
587 Fifth Ave
Suite 801
New York, NY 10017-8747
Phone
(212) 249-1600
Fax
(212) 288-0809
NPI assigned
Jul 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME 120290 FL
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 272478 NY Primary

Addresses

Primary practice location

587 Fifth Ave
Suite 801
New York, NY 10017-8747

Mailing address

322 W 57TH St Apt 30Q
New York, NY 10019-3712
Phone (248) 881-7971

Other practice location 1

1951 NW 7th Ave Ste 300
Miami, FL 33136-1112
Phone (305) 902-6347

Other practice location 2

34 S Broadway Ste 711
White Plains, NY 10601-4427
Phone (914) 946-4700

Other practice location 3

358 Fifth Ave
Suite 1003
New York, NY 10001
Phone (914) 946-4700

Other practice location 4

721 W Colonial Dr
Orlando, FL 32804-7309
Phone (407) 245-8501

Other identifiers 1

IdentifierTypeStateIssuer
013184700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY, MI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150211002194 FL Practitioner - Psychiatry 0648595793 Reassigns benefits to 5 organizations
I20201211002523 NY Practitioner - Psychiatry 0648595793 Reassigns benefits to 1 organization
I20210504002368 MI Practitioner - Psychiatry 0648595793 Reassigns benefits to 2 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
Psychiatry of Texas PLLCGroup PAC ID 0345573598, 418 clinicians

Practice addresses (Care Compare)

109 W Fortune St
Apt 1516
Tampa, FL 33602-3221
Phone (917) 300-9610

181 Kenwood Ave
Suite 10
Oneida, NY 13421-2802
Phone 8328694818235

4700 N Habana Ave
Suite 601
Tampa, FL 33614-7160
Phone 8328694818235

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 120290FLMDPsychiatry Physician
272478NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psychplus Associates of Michigan, PLLC Psychiatry CurrentSince May 1, 2025 Accepting new patients
Psychiatry of Texas PLLC Psychiatry CurrentSince Aug 1, 2024 Accepting new patients
South County Mental Health Center, Inc. CurrentSince Dec 17, 2014 Accepting new patients
Triumph Psychiatry LLC Psychiatry CurrentSince Jan 28, 2022 Accepting new patients
Psychplus Medical Associates, PLLC Psychiatry CurrentSince Mar 4, 2025 Accepting new patients
Psychplus Medical Associates of Michigan, PLLC Psychiatry CurrentSince May 1, 2025 Accepting new patients
Child & Family Medical, PLLC Psychiatry PastSince Jan 26, 2022 Accepting new patients
Alexander L Levine PastSince Sep 25, 2022 Accepting new patients

Locations

250 2nd St E
Ste 4C
Bradenton, FL 34208
Phone (941) 744-5860

16158 S Military Trl
Delray Beach, FL 33484
Phone (561) 495-0522

6700 Winkler Rd
Ste 4
Fort Myers, FL 33919
Phone 8328694818 ext. 235

5995 SE Community Dr
Stuart, FL 34997
Phone (727) 424-3427

4700 N Habana Ave
Ste 601
Tampa, FL 33614
Phone (201) 706-1143

126 College St
Ste A
Battle Creek, MI 49037
Phone (269) 969-6000

290 Town Center Dr
Ste 141
Dearborn, MI 48126

5901 Chase Rd
Ste 210
Dearborn, MI 48126
Phone (313) 945-6650

15400 Michigan Ave
Ste 1
Dearborn, MI 48126
Phone (313) 207-5767

3512 Coolidge Rd
East Lansing, MI 48823
Phone (517) 318-5889

1717 Shaffer St
Ste 209
Kalamazoo, MI 49048
Phone (269) 342-2991

181 Kenwood Ave
Ste 10
Oneida, NY 13421

7877 Willow Chase Blvd
Houston, TX 77070
Phone 8328694818109

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26014/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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": "1280534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1073827135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W 57TH ST APT 30Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193712",
            "telephone_number": "248-881-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 FIFTH AVE",
            "address_2": "SUITE 801",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100178747",
            "telephone_number": "212-249-1600",
            "fax_number": "212-288-0809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1951 NW 7th Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361112",
            "country_code": "US",
            "telephone_number": "305-902-6347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34 S Broadway Ste 711",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106014427",
            "country_code": "US",
            "telephone_number": "914-946-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "358 Fifth Ave",
            "address_2": "Suite 1003",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10001",
            "country_code": "US",
            "telephone_number": "914-946-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "721 W Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328047309",
            "country_code": "US",
            "telephone_number": "407-245-8501",
            "fax_number": "407-245-8503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHFOUZ",
        "first_name": "RODWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-31",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 120290",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "272478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013184700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.