Individual provider Active NPI

John Christian Douglas, M.D.

  • Psychiatry Physician
  • Hartsdale, NY
National Provider Identifier
1366769804
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
269011 Issued in NY
Practice address
141 N Central Ave
Hartsdale, NY 10530-1912
Phone
(914) 949-7699
Fax
(914) 949-3224
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A101028 CA
Addiction Psychiatry Physician 2084P0802X 053165 CT
Psychiatry Physician 2084P0800X 269011 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

141 N Central Ave
Hartsdale, NY 10530-1912

Mailing address

208 Valley Rd
New Canaan, CT 06840-3812
Phone (203) 801-2231

Other practice location 1

949 Bridgeport Ave
Milford, CT 06460-3142
Phone (203) 878-6365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141006001771 CT Practitioner - Psychiatry 7719107242 Reassigns benefits to 2 organizations
I20190502000090 NY Practitioner - PsychiatryPractitioner - Addiction Medicine 7719107242 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101028CAMDPsychiatry Physician
269011NYMDPsychiatry Physician
053165CTMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St.Vincent' Hospital Westchester Psych CurrentSince Sep 1, 2024 Accepting new patients
St Josephs Hospital Yonkers CurrentSince Sep 1, 2024 Accepting new patients
Bridges Healthcare Inc. CurrentSince Jan 4, 2026 Accepting new patients
Silver Hill Hospital, Inc CurrentSince Jul 24, 2014 Accepting new patients
St. Joseph'S Hospital Yonkers Current Accepting new patients
St.Vincent'S Hospital Westchester a Division of Saint Joseph'S Medical Past Accepting new patients
Westchester Jewish Community Services Past Accepting new patients

Locations

949 Bridgeport Ave
Milford, CT 06460
Phone (203) 301-2308

208 Valley Rd
New Canaan, CT 06840
Phone (203) 966-3561

275 North St
Harrison, NY 10528
Phone (914) 925-5211

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bridgesct/r4/

Organizations & group practices 7

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1366769804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 VALLEY RD",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068403812",
            "telephone_number": "203-801-2231",
            "fax_number": "203-801-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N CENTRAL AVE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301912",
            "telephone_number": "914-949-7699",
            "fax_number": "914-949-3224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "949 Bridgeport Ave",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064603142",
            "country_code": "US",
            "telephone_number": "203-878-6365",
            "fax_number": "203-301-2397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JOHN",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A101028",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CT",
            "license": "053165",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "269011",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.