Individual provider Active NPI

Christina L. Persaud, M.D.

  • Psychiatry Physician
  • Bronx, NY
National Provider Identifier
1689069650
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
296840 Issued in NY
Practice address
1 Fordham PLZ FL 5
Bronx, NY 10458-5871
Phone
(718) 933-2400
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 296840 NY Primary

Addresses

Primary practice location

1 Fordham PLZ FL 5
Bronx, NY 10458-5871

Mailing address

1623 3Rd Ave Apt 37G
New York, NY 10128-3646
Phone (718) 570-2004

Other practice location 1

34 3rd Ave
New York, NY 10003-5504
Phone (844) 384-2779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190719000601 NY Practitioner - Psychiatry 3971818576 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Psychiatry CurrentSince Jun 21, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients
Boston University Dermatology, Inc. Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1 Fordham Plz
Fl 5
Bronx, NY 10458
Phone (718) 741-9505

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.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1689069650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 3RD AVE APT 37G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283646",
            "telephone_number": "718-570-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FORDHAM PLZ FL 5",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585871",
            "telephone_number": "718-933-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100035504",
            "country_code": "US",
            "telephone_number": "844-384-2779",
            "fax_number": "713-903-3799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "CHRISTINA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "296840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.