Individual provider Active NPI

Kathryn Kelly, DO

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1912657982
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
335444 Issued in NY
Practice address
45 Rivington St
New York, NY 10002-1304
Phone
(332) 243-1800
NPI assigned
Mar 24, 2022
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 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 335444 NY Primary

Addresses

Primary practice location

45 Rivington St
New York, NY 10002-1304

Mailing address

45 Rivington St
New York, NY 10002-1304
Phone (332) 243-1800

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
I20260113001760 NY Practitioner - Psychiatry 6608352323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Fifth Avenue Counseling Center, Inc.Group PAC ID 9739246125, 24 clinicians

Practice addresses (Care Compare)

5 E 17TH St
FL 2
New York, NY 10003-1949
Phone (212) 989-2990

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
335444NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Fifth Avenue Counseling Center, Inc. CurrentSince Dec 1, 2025 Accepting new patients

Locations

5 E 17th St
Fl 2
New York, NY 10003
Phone (212) 989-2900

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, 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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1912657982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RIVINGTON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100021304",
            "telephone_number": "332-243-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RIVINGTON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100021304",
            "telephone_number": "332-243-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHRYN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "335444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.