Individual provider Active NPI

Georgio Legerme, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1669054045
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
337436 Issued in NY
Practice address
150 Broadway RM 502
New York, NY 10038-4380
Phone
(845) 279-5908
NPI assigned
Apr 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A203816 CA
Psychiatry Physician 2084P0800X ME172766 FL
Psychiatry Physician 2084P0800X 337436 NY Primary

Addresses

Primary practice location

150 Broadway RM 502
New York, NY 10038-4380

Mailing address

150 Broadway RM 502
New York, NY 10038-4380
Phone (845) 279-5908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 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
I20260312002369 CA Practitioner - Psychiatry 6103220074 Reassigns benefits to 1 organization
I20260624001065 NY Practitioner - Psychiatry 6103220074

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carmel Psychological Health PCGroup PAC ID 4385530351, 222 clinicians

Practice addresses (Care Compare)

150 Broadway
RM 502
New York, NY 10038-4380
Phone (845) 279-5908

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A203816CAMDPsychiatry Physician
ME172766FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation Psychiatry CurrentSince Feb 23, 2026 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1619308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1669054045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BROADWAY RM 502",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384380",
            "telephone_number": "845-279-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BROADWAY RM 502",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384380",
            "telephone_number": "845-279-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGERME",
        "first_name": "GEORGIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-25",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A203816",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME172766",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "337436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.