Individual provider Active NPI

Victor Demetrio, DO

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1275276453
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
326162 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-5506
NPI assigned
Apr 15, 2022
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Psychiatry Physician 2084P0800X 326162 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402

Other names 1

  • Victor Henrique Demetrio Pereira Other name

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
I20250617002442 NY Practitioner - Psychiatry 3274044110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
326162NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2025 Accepting new patients
New York University CurrentSince Jul 1, 2025 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1275276453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIO",
        "first_name": "VICTOR",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "326162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTOR",
            "last_name": "DEMETRIO PEREIRA",
            "middle_name": "HENRIQUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.