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DR. KELLIE NICOLE GERGOUDIS MD, MSCR
NPI 1730742099
Psychiatry & Neurology - Psychiatry in New York, NY

Active since April 22, 2019PECOS EnrolledAccepts Medicare Assignment
1 PARK AVE FL 8, NEW YORK, NY 10016(212) 263-7419(212) 263-7460 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 19, 2024, May 20, 2019, Apr 22, 2019 (3 updates tracked since 2019).

About Dr. Kellie Nicole Gergoudis Md, Mscr NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLIE NICOLE GERGOUDIS MD, MSCR (NPI 1730742099) is an individual psychiatry provider in New York, New York, licensed in New York (318870) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1730742099
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameDR. KELLIE NICOLE GERGOUDISCredential: MD, MSCR
Location Address1 PARK AVE FL 8New York, NY 10016-5802
Mailing Address1 Park Ave Fl 8New York, NY 10016-5802 · (212) 263-7419 · Fax (212) 263-7460
Phone(212) 263-7419
Fax(212) 263-7460
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateApril 22, 2019
Last NPPES UpdateSeptember 19, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2024
✔ NPI 1730742099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in NY · 318870
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1 PARK AVE FL 8, New York, NY 10016
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kellie Nicole Gergoudis Md, Mscr is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133669500
PECOS Enrollment IDI20240912000201
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$198.19 typical visit price
range $65.69 – $198.19
Typical copayment $49.54 (range $16.42 – $49.54)
Most-billed visit code 99205
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADAM DEAN MANDEL PHD
Psychologist (Clinical)
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (212) 263-7419
KATHERINE GRACE NORDGREN MD
Psychiatry & Neurology (Psychiatry)
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (212) 263-7419
DR. ARSLAAN ARSHED
Psychiatry & Neurology (Psychiatry)
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (646) 598-1206
DR. PATRICK WARREN ARTHUR MD
Psychiatry & Neurology (Psychiatry)
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (646) 754-4869
DR. JOO HWAN SHIN PSYD
Psychologist (Clinical)
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (412) 496-3719
YINGCHENG XU M.D.
Psychiatry & Neurology (Psychiatry)
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (212) 263-7419
DR. BRANDON WEISS PHD
Psychologist
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (415) 941-9624
NOGA MIRON
Psychologist
1 PARK AVE FL 8
NEW YORK, NY 10016
New York County (212) 263-7419

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kellie Gergoudis's NPI number?

The NPI number for Kellie Gergoudis is 1730742099. It was assigned to this individual provider in the NPPES registry on April 22, 2019.

Where is Kellie Gergoudis located?

Kellie Gergoudis practices at 1 Park Ave Fl 8, New York, NY 10016. The listed phone number is (212) 263-7419.

What is Kellie Gergoudis's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Kellie Gergoudis enrolled in Medicare?

Yes. Kellie Gergoudis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kellie Gergoudis accept?

Health plans from Providence Health Plan list Kellie Gergoudis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kellie Gergoudis was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.