Michael Petetit, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

305453 Issued in NY

Practice address

109 W 27TH St RM 5S
New York, NY 10001-6208

Phone

(833) 351-8255

NPI assigned

May 18, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 4, 2022 through Dec 4, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: centerfordevelopmentalpsychiatry.michaelpetetit@156723.advancedmd-direct.com

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.

• Jason Dean, MD LLC

  • Child & Adolescent Psychiatry Physician
  • Teaneck, NJ
  • NPI 1659045243
  NPD

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1275980385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETETIT",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "305453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Peterson
• Remmy Peterson, DNP, PMHNP-BC
• Renae Michelle Peterson, LMSW
• Sarah Jane Peterson
• Tammy Peterson
• Caroline Petgrave, LCSW-R
• Katherine Alexandra Petherbridge, RN
• Elder Berry Petilla
• Anthony Louis Petillo, RPH
• Dyjenie Petit del, P.A

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.