Active NPI
Panagiotis Roussos, M.D., PH.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1386886547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 275808
- Practice address
- 1470 Madison Ave
New York, NY 10029-6542 - Phone
- (212) 824-8982
- NPI assigned
- Apr 1, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 275808 | NY | Primary |
Addresses
Primary practice location
1470 Madison Ave
New York, NY 10029-6542
Mailing address
18 E 105TH St
Apt 3
New York, NY 10029-4436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 275808 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620432000000",
"number": "1386886547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 E 105TH ST",
"address_2": "APT 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100294436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1470 MADISON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296542",
"telephone_number": "212-824-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSSOS",
"first_name": "PANAGIOTIS",
"name_prefix": "Prof.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-01",
"last_updated": "2021-05-08",
"certification_date": "2021-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "275808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.