Individual provider Active NPI

Mark Andrew Krushelnycky, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1649490442
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
208671 Issued in NY
Practice address
39 E 78TH St
Suite 501
New York, NY 10021-0213
Phone
(212) 396-0204
Fax
(212) 396-0746
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 208671 NY Primary
Child & Adolescent Psychiatry Physician 2084P0804X 208671 NY

Addresses

Primary practice location

39 E 78TH St
Suite 501
New York, NY 10021-0213

Mailing address

39 E 78TH St
Suite 501
New York, NY 10021-0213
Phone (212) 396-0204

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

State licenses

LicenseStateTypeSpecialty
208671NYMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1649490442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 E 78TH ST",
            "address_2": "SUITE 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210213",
            "telephone_number": "212-396-0204",
            "fax_number": "212-396-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 E 78TH ST",
            "address_2": "SUITE 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210213",
            "telephone_number": "212-396-0204",
            "fax_number": "212-396-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSHELNYCKY",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "208671",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "208671",
            "primary": false
        }
    ],
    "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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.