Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kellie Nicole Gergoudis, MD, MSCR

Individual provider Psychiatry Physician · NPI 1730742099

Dr. Kellie Nicole Gergoudis, MD, MSCR is a Psychiatry in New York, New York. Qualified in 2019, 7 years ago. Practices with New York University, a 5,884-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2019
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1 Park Ave Fl 8
New York, NY 10016-5802
Phone: (212) 263-7419
Fax: (212) 263-7460
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 318870 (NY)

Record details

NPI number1730742099
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD , MSCR
Sole proprietorNo
NPI enumeratedApril 22, 2019
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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