Individual provider Active NPI

Justin Spencer Pereira, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1912402348
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
303974 Issued in NY
Practice address
109 W 27TH St Ste 5S
New York, NY 10001-6208
Phone
(833) 351-8255
Fax
(888) 815-3583
NPI assigned
Mar 27, 2018
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 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 303974 NY Primary

Addresses

Primary practice location

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

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, CT3 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
I20220630001097 NJ Practitioner - Psychiatry 1153675756 Reassigns benefits to 1 organization
I20220706000032 NY Practitioner - Psychiatry 1153675756 Reassigns benefits to 1 organization
I20230203002228 CT Practitioner - Psychiatry 1153675756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD New Jersey Psychiatry Services LLCGroup PAC ID 8921452350, 54 clinicians

Practice addresses (Care Compare)

53 Frontage Rd
Hampton, NJ 08827-4031
Phone (833) 351-8255

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD New Jersey Psychiatry Services LLC Psychiatry CurrentSince Oct 31, 2023 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jul 1, 2022 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients

Locations

777 W Putnam Ave
Ste 300
Greenwich, CT 06830
Phone (203) 542-2808

53 Frontage Rd
Fl 1
Hampton, NJ 08827
Phone (908) 386-2572

525 Route 73 N
Ste 117
Marlton, NJ 08053
Phone (609) 200-0444

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 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1912402348",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "JUSTIN",
        "middle_name": "SPENCER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "303974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.