NPIMap

Organization Active NPI

MCCD KS Psychiatry Services PA

  • Psychiatry Physician
  • Overland Park, KS
National Provider Identifier
1487422234
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MCCD KS PSYCHIATRY SERVICES PA
Practice address
8101 College Blvd Ste 100
Overland Park, KS 66210-2671
Phone
(917) 634-5311
NPI assigned
Dec 12, 2023
Last updated
Mar 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Dr. Georgia Gaveras, DONPI 1801951090
Title
Owner/Chief Medical Officer
Phone
(917) 309-7915

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

8101 College Blvd Ste 100
Overland Park, KS 66210-2671

Mailing address

109 W 27TH St # 5S
New York, NY 10001-6208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240102000281 KS Part B Supplier - Clinic/Group Practice 4385094598 Receives reassigned benefits from 12 practitioners
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1487422234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST # 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 COLLEGE BLVD STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102671",
            "telephone_number": "917-634-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCD KS PSYCHIATRY SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "GAVERAS",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "OWNER/CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "917-309-7915",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.