Empire State Psychiatric Medicine PLLC
Organization Active NPI Psychiatry Physician · New York, NY
NPI 1245087261 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1245087261
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- EMPIRE STATE PSYCHIATRIC MEDICINE PLLC
- Practice address
- 315 Madison Ave RM 2000
New York, NY 10017-5416 - Phone
- (646) 661-5225
- NPI assigned
- May 6, 2024
- Organization subpart
- No
Authorized official
- Name
- Dr. Frank Perkins, MD
- Title
- Partner
- Phone
- (256) 656-0145
Practitioners 22
-
Ashley Leann Berg, PMHNP-BC
-
Amanda Botros, NP
-
Kristy Marie Colangelo, APRN
-
Lindsay Dunlop, NPP, FNP
-
Megan Guerrera, PMHNP
-
Trevor Brown, DNP, PMHNP-BC
-
Basha Brody, NP
-
Shane Daniel Gallagher, PMHNP
-
Rachel Koreen, DO
-
Jordan Taylor Young, PMHNP
-
Aida Melendez, PMHNP-BC
-
Jarrod Adam Marks, M.D.
-
Frank Perkins IV, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241001003131 | NY | Part B Supplier - Clinic/Group Practice | 0840721825 |
Receives reassigned benefits from 19 practitioners Practice locations: New York, NY |
National Provider Directory
Locations
315 Madison Ave
Rm 2000
New York, NY 10017
Phone (646) 661-5225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Mental Health Counselor |
101YM0800X | |||
| Psychoanalyst |
102L00000X | |||
| Psychologist |
103T00000X | |||
| Cognitive & Behavioral Psychologist |
103TB0200X | |||
| Clinical Psychologist |
103TC0700X | |||
| Counseling Psychologist |
103TC1900X | |||
| Social Worker |
104100000X | |||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Neurology Physician |
2084N0400X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Nurse Practitioner |
363L00000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
315 Madison Ave RM 2000
New York, NY 10017-5416
Mailing address
PO Box 2786
Ridgeland, MS 39158-2786
Phone (256) 656-0145
Other providers in New York, NY
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All providers in New York, NY · Psychiatry Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.