Active NPI
Kristofer Willers, MD
- Psychiatry Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 288089
- Practice address
- 109 W 27TH St RM 5S
New York, NY 10001-6208 - Phone
- (833) 351-8255
- Fax
- (888) 815-3583
- NPI assigned
- Mar 26, 2018
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 314147-01 | NY | |
| Psychiatry Physician | 2084P0800X | A177531 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 288089 | MA | Primary |
Addresses
Primary practice location
109 W 27TH St RM 5S
New York, NY 10001-6208
Mailing address
32 Madison St # 2
Somerville, MA 02143-1209
Phone (617) 804-7970
Other practice location 1
300 Baker Ave Ste 300
Concord, MA 01742-2124
Phone (833) 351-8255
Other practice location 2
100 Pine St Ste 1250
San Francisco, CA 94111-5235
Phone (833) 351-8255
Other names 1
- Dr. Kristofer Joondeph-Breidbart
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Massachusetts Medical School, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
265 Franklin St
Suite 1702
Boston, MA 02110-3144
Phone (833) 351-8255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A177531 | CA | MD | Psychiatry Physician |
| 288089 | MA | MD | Psychiatry Physician |
| 314147-01 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD FL Psychiatry Services PA | Psychiatry | Current | Accepting new patients |
Locations
265 Franklin St
Ste 1702
Boston, MA 02110
Phone (203) 721-6500
300 Baker Ave
Ste 300
Concord, MA 01742
Phone (864) 336-2731
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
Organizations & group practices 1
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": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771977600000",
"number": "1891290516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 MADISON ST # 2",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021431209",
"telephone_number": "617-804-7970",
"fax_number": "617-203-6011"
},
{
"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": "300 Baker Ave Ste 300",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "MA",
"postal_code": "017422124",
"country_code": "US",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Pine St Ste 1250",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941115235",
"country_code": "US",
"telephone_number": "833-351-8255",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLERS",
"first_name": "KRISTOFER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-26",
"last_updated": "2026-02-25",
"certification_date": "2026-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "314147-01",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A177531",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "288089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTOFER",
"last_name": "JOONDEPH-BREIDBART",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
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 Feb 25, 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.