Active NPI
Georgio Legerme, MD
- Psychiatry Physician
- New York, NY
National Provider Identifier
1669054045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 337436
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| A203816 | CA | MD | Psychiatry Physician |
| ME172766 | FL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mellow Medical Inc a Professional Corporation | Psychiatry | Current | 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
- 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.
-
- Psychiatry Physician
- West Hollywood, CA
- NPI 1407275886
-
- Psychologist
- Carmel, NY
- NPI 1720194335
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.