Individual provider Active NPI

Kavin Fatehchand, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1295354116
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
312145 Issued in NY
Practice address
630 West 168TH Street, New York, Ny 10032
New York, NY 10032
Phone
(585) 406-3567
NPI assigned
Apr 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 312145 NY Primary

Addresses

Primary practice location

630 West 168TH Street, New York, Ny 10032
New York, NY 10032

Mailing address

4425 Plymouth Rock CT
Columbus, OH 43230-1595
Phone (585) 406-3567

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
I20240905003878 NY Practitioner - Psychiatry 8527508407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Ohio State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jul 19, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Psychiatry Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 19, 2024 Accepting new patients
Trustees of Columbia University in Department of Psychiatry Psychiatry PastSince Jan 24, 2017 Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

710 W 168th St
#12
New York, NY 10032
Phone (212) 305-9758

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1295354116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 PLYMOUTH ROCK CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432301595",
            "telephone_number": "585-406-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 WEST 168TH STREET, NEW YORK, NY 10032",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "585-406-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEHCHAND",
        "first_name": "KAVIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "312145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.