Individual provider Active NPI

Phillip Azouz, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1386105138
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
158336 Issued in FL
Practice address
109 W 27TH St Ste 5S
New York, NY 10001-0265
Phone
(561) 291-8711
Fax
(716) 214-1089
NPI assigned
Mar 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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 158336 FL Primary

Addresses

Primary practice location

109 W 27TH St Ste 5S
New York, NY 10001-0265

Mailing address

PO Box 801208
Dallas, TX 75380-1208
Phone (561) 291-8711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, TX3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230804001358 NY Practitioner - Psychiatry 4385005404 Reassigns benefits to 1 organization
I20230807002848 FL Practitioner - Psychiatry 4385005404 Reassigns benefits to 1 organization
I20231025001738 TX Practitioner - Psychiatry 4385005404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

1301 Riverplace Blvd
Suite 800
Jacksonville, FL 32207-9032
Phone (833) 351-8255

1400 N Coit Rd
Talkiatry Suite 302
McKinney, TX 75071-6656
Phone (917) 634-5311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158336FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mipaz Medical Current Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Aug 30, 2023 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Aug 30, 2023 Accepting new patients

Locations

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

1301 Riverplace Blvd
Jacksonville, FL 32207

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

1400 N Coit Rd
Ste 302
McKinney, TX 75071
Phone (214) 504-3005

Organizations & group practices 3

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1386105138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801208",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753801208",
            "telephone_number": "561-291-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100010265",
            "telephone_number": "561-291-8711",
            "fax_number": "716-214-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZOUZ",
        "first_name": "PHILLIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "158336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.