Individual provider Active NPI

Jonathan Myrtil, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1669905451
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
TRN24324 Issued in FL
Practice address
109 W 27TH St RM 5S
New York, NY 10001-6208
Phone
(917) 634-5311
NPI assigned
Apr 7, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 TRN24324 FL Primary

Addresses

Primary practice location

109 W 27TH St RM 5S
New York, NY 10001-6208

Mailing address

1301 Riverplace Blvd
Jacksonville, FL 32207-9047
Phone (321) 300-2108

Other practice location 1

101 N Monroe St Ste 800
Tallahassee, FL 32301-1500
Phone (321) 300-2108

Other practice location 2

15000 Weston Pkwy
Cary, NC 27513-2118
Phone (919) 925-3927

Other practice location 3

300 Colonial Center Pkwy Ste 100
Roswell, GA 30076-4892
Phone (470) 670-6319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY, NC, GA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20210622003580 FL Practitioner - Psychiatry 1759782238 Reassigns benefits to 1 organization
I20230911004006 NY Practitioner - Psychiatry 1759782238 Reassigns benefits to 1 organization
I20240214001076 NC Practitioner - Psychiatry 1759782238 Reassigns benefits to 1 organization
I20240819002578 GA Practitioner - Psychiatry 1759782238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

1301 Riverplace Blvd
Suite 800
Jacksonville, FL 32207-9032
Phone (833) 351-8255

300 Colonial Ctr Pkwy
Roswell, GA 30076-4899
Phone (833) 351-8255

555 Fayetteville St
Suite 201
Raleigh, NC 27601-3034
Phone (833) 351-8255

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
75.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN24324FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Oct 30, 2023 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Sep 1, 2023 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

101 N Monroe St
Ste 800
Tallahassee, FL 32301
Phone (321) 300-2108

300 Colonial Center Pkwy
Ofc 12
Roswell, GA 30076
Phone (833) 351-1825

10 Glenlake Pkwy
Ste 130
Sandy Springs, GA 30328
Phone (678) 230-7095

555 Fayetteville St
Ste 201
Raleigh, NC 27601
Phone (919) 780-4178

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1669905451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 RIVERPLACE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079047",
            "telephone_number": "321-300-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 N Monroe St Ste 800",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323011500",
            "country_code": "US",
            "telephone_number": "321-300-2108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15000 Weston Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275132118",
            "country_code": "US",
            "telephone_number": "919-925-3927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Colonial Center Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764892",
            "country_code": "US",
            "telephone_number": "470-670-6319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYRTIL",
        "first_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "TRN24324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.