Jeremy Douglas Kidd, MD, MPH

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

275949-1 Issued in NY

Practice address

1051 Riverside Dr
New York, NY 10032-1007

Phone

(212) 543-5553

NPI assigned

Apr 2, 2013

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

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai West Hospital, New York, NY, CCN 330046

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Roosevelt Hospital Center

  • General Acute Care Hospital
  • New York, NY
  • NPI 1104982917
  Care Compare affiliation
• St. Lukes Roosevelt Hospital Center

  • Methadone Clinic
  • New York, NY
  • NPI 1609476357

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356684922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DR UNIT 66",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321007",
            "telephone_number": "347-762-0527",
            "fax_number": "203-318-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321007",
            "telephone_number": "212-543-5553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W 72nd St Ste 5E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100233204",
            "country_code": "US",
            "telephone_number": "347-762-0527",
            "fax_number": "203-318-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JEREMY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "275949-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kid Dentist Nyc PLLC
• Redet Kidane
• Amelia Chayet Kidd, LCSW
• Christen Linnea Kidd, MD
• Donnet Angela Kidd
• Madeline Catherine Kidd, D.O.
• Patricia Marie Kidd
• Kidney Hypertension Specialists of Ny PC
• Christopher Steven Kido, LCSW
• Kids of New York Applied Behavior Analysis, PLLC

• 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.