Individual provider Active NPI

Sonia Demetrios, M.D.

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1598068579
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA09995300 Issued in NJ
Practice address
1276 Fulton Ave
Bronx, NY 10456-3402
Phone
(718) 466-7281
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME129604 FL
Child & Adolescent Psychiatry Physician 2084P0804X 25MA09995300 NJ
Child & Adolescent Psychiatry Physician 2084P0804X ME129604 FL
Psychiatry Physician 2084P0800X 25MA09995300 NJ Primary

Addresses

Primary practice location

1276 Fulton Ave
Bronx, NY 10456-3402

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 466-7281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180613000791 NJ Practitioner - Psychiatry 9335382464 Reassigns benefits to 1 organization
I20201125000714 FL Practitioner - Psychiatry 9335382464

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

175 High St
Newton, NJ 07860-1004
Phone (973) 383-2121

Hospital & facility affiliations

  • Newton Medical Center Hospital, Newton, NJ, CCN 310028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Dec 12, 2020 Accepting new patients
Essex Psychiatric Center for Children & Adults LLC Child & Adolescent Psychiatry Current Accepting new patients
Ahs Hospital Corp. Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

175 High St
Newton, NJ 07860
Phone (973) 383-2121

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.

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": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1598068579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-466-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-466-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIOS",
        "first_name": "SONIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME129604",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA09995300",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME129604",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09995300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.