Individual provider Active NPI

Megan Marumoto, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1760472765
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2067682UPD Issued in NY
Practice address
109 W 27TH St RM 5S
New York, NY 10001-6208
Phone
(833) 351-8255
Fax
(888) 815-3583
NPI assigned
Oct 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0069278 CO
Child & Adolescent Psychiatry Physician 2084P0804X MD-9818 HI
Child & Adolescent Psychiatry Physician 2084P0804X 0101257141 VA
Psychiatry Physician 2084P0800X 2067682UPD NY Primary

Addresses

Primary practice location

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

Mailing address

109 W 27TH St Ste 5S
New York, NY 10001-6208
Phone (833) 351-8255

Other practice location 1

2373 Central Park Blvd Unit 100
Denver, CO 80238-2300
Phone (833) 351-8255

Other practice location 2

150 Riverside Pkwy Ste 115
Fredericksburg, VA 22406-1094
Phone (833) 351-8255

Other practice location 3

2800 Eisenhower Ave Ste 220
Alexandria, VA 22314-4587
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220727003293 CO Practitioner - Psychiatry 6800278516 Reassigns benefits to 1 organization
I20220920000190 NY Practitioner - Psychiatry 6800278516 Reassigns benefits to 1 organization
I20250502000863 VA Practitioner - Psychiatry 6800278516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD Psychiatry Services PLLCGroup PAC ID 4082049036, 206 clinicians

Practice addresses (Care Compare)

109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0069278COMDPsychiatry Physician
2067682UPDNYMDPsychiatry Physician
MD-9818HIMDChild & Adolescent Psychiatry Physician

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1760472765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "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": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "833-351-8255",
            "fax_number": "888-815-3583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2373 Central Park Blvd Unit 100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802382300",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Riverside Pkwy Ste 115",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224061094",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Eisenhower Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223144587",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARUMOTO",
        "first_name": "MEGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0069278",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "HI",
            "license": "MD-9818",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101257141",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "2067682UPD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.