Individual provider Active NPI

Sallie Joellin Hadley, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1407978786
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
204720 Issued in NY
Practice address
109 W 27TH St
New York, NY 10001-0265
Phone
(917) 634-5311
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 204720 NY
Child & Adolescent Psychiatry Physician 2084P0804X 204720 NY
Psychiatry Physician 2084P0800X 204720 NY Primary

Addresses

Primary practice location

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

Mailing address

109 W 27TH St RM 5S
New York, NY 10001-6208
Phone (917) 634-5311

Other names 1

  • Sallie J Hadley Other name

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
I20071005000777 NY Practitioner - Psychiatry 5991890824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Icahn School of Medicine at Mount Sinai, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD Psychiatry Services PLLCGroup PAC ID 4082049036, 206 clinicians

Practice addresses (Care Compare)

109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204720NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince Dec 1, 2012 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jul 25, 2022 Accepting new patients
Premier Healthcare, Inc. Current Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

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

460 W 34th St
New York, NY 10001
Phone (212) 273-6515

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

109 W 27th St
New York, NY 10001
Phone (332) 206-6054

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1407978786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100010265",
            "telephone_number": "917-634-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "SALLIE",
        "middle_name": "JOELLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "204720",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "204720",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "204720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLIE",
            "last_name": "HADLEY",
            "middle_name": "J",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.