Active NPI
Lauren Mordukhaev, MD
- Psychiatry Physician
- King of Prussia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD491365
- Practice address
- 680 American Avenue
Suite 302 (Private Office 322)
King of Prussia, PA 19406 - Phone
- (833) 351-8255
- NPI assigned
- Mar 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD491365 | PA | Primary |
| Psychiatry Physician | 2084P0800X | 337487 | NY |
Addresses
Primary practice location
680 American Avenue
Suite 302 (Private Office 322)
King of Prussia, PA 19406
Mailing address
PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255
Other practice location 1
109 W 27th St Rm 5S
New York, NY 10001-6208
Phone (833) 351-8255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251111000193 | NY | Practitioner - Psychiatry | 5698265361 | Reassigns benefits to 1 organization |
| I20251121002145 | PA | Practitioner - Psychiatry | 5698265361 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255
2418 E York St
Talkiatry
Philadelphia, PA 19125-3006
Phone (833) 351-8255
680 American Ave
Suite 302
King of Prussia, PA 19406-4023
Phone (833) 351-8255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337487 | NY | MD | Psychiatry Physician |
| MD491365 | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD Psychiatry Services PLLC | Psychiatry | Current | Accepting new patients |
| MCCD FL Psychiatry Services PA | Psychiatry | Current | Accepting new patients |
Locations
109 W 27th St
#55
New York, NY 10001
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
680 American Ave
Ste 302
King of Prussia, PA 19406
Phone (215) 821-4493
2418 E York St
Philadelphia, PA 19125
Phone (215) 575-5906
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": "1585180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1700413754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24449",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100870589",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 AMERICAN AVENUE",
"address_2": "SUITE 302 (PRIVATE OFFICE 322)",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "19406",
"telephone_number": "833-351-8255"
}
],
"practiceLocations": [
{
"address_1": "109 W 27th St Rm 5S",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100016208",
"country_code": "US",
"telephone_number": "833-351-8255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORDUKHAEV",
"first_name": "LAUREN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-26",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD491365",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "337487",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.