Individual provider Active NPI

Vicente J Liz Defillo, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1508032954
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
270405 Issued in NY
Practice address
30 W 60TH St Apt 1F
New York, NY 10023-7906
Phone
(646) 359-1012
Fax
(718) 960-2023
NPI assigned
May 6, 2008
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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 270405 NY Primary

Addresses

Primary practice location

30 W 60TH St Apt 1F
New York, NY 10023-7906

Mailing address

1295 5TH Ave Apt 33D
New York, NY 10029-3134
Phone (646) 359-1012

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
I20110817000148 NY Practitioner - Psychiatry 4183893779 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1265 Franklin Ave
Bronx, NY 10456-3501

1276 Fulton Ave
Bronx, NY 10456-3402

1650 Grand Concourse
Bronx, NY 10457-7606

30 W 60TH St
Apt 1F
New York, NY 10023-7906
Phone (646) 359-1012

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Psychiatry CurrentSince Jan 1, 2015 Accepting new patients
Bronxcare Health System Psychiatry Current Accepting new patients
Bronxcare Health System CurrentSince Jan 1, 2015 Accepting new patients
Bronxcare Health System Past Accepting new patients
Vicente J Liz Defillo PastSince Oct 3, 2013 Accepting new patients

Locations

1276 Fulton Ave
#208
Bronx, NY 10456
Phone (718) 901-8911

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1508032954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 5TH AVE APT 33D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293134",
            "telephone_number": "646-359-1012",
            "fax_number": "718-960-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237906",
            "telephone_number": "646-359-1012",
            "fax_number": "718-960-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZ DEFILLO",
        "first_name": "VICENTE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "270405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.