Does this practice accept insurance?

No. This is a direct-pay practice. Insurance is not billed. The flat fee is $800 per visit, regardless of visit type.

Do I need a referral to make an appointment?

No referral is required. Patients and families can contact the practice directly.

What areas does Dr. Zakhari cover for house calls?

House calls are available throughout Manhattan. Office visits are available at 1115 Broadway. Telehealth is available to patients located in New York State.

What age groups does this practice treat?

This practice treats children, adolescents, adults, and older adults. Family involvement is incorporated when appropriate.

What conditions does this practice treat?

Areas of focus include geriatric psychiatry, anxiety and mood disorders, men's mental health, sexual health concerns, addiction and compulsive behaviors, and family and young adult mental health.

Is the fee the same for house calls, office visits, and telehealth?

Yes. The fee is $800 per visit regardless of visit format.

Can documentation be provided for insurance reimbursement?

Documentation for out-of-network submission can be provided upon request, but reimbursement is not guaranteed and is the patient's responsibility to pursue.

For Referring Clinicians | psychiatryhousecalls

For Referring Clinicians

Psychiatric care for clinically complex, privacy-sensitive, and home-based cases in Manhattan. For care managers, physicians, therapists, elder care professionals, and attorneys.

Practice Overview

When your patient needs more than a standard referral

This practice occupies a specific niche in Manhattan psychiatric care: direct-pay, concierge access, house calls when needed, and strong clinical depth across psychiatry, primary care, geriatrics, and addiction.

It is designed for the kinds of cases that are difficult to fit into large systems — patients who need privacy, patients who cannot or will not easily leave home, patients with complex medical-psychiatric overlap, and patients who have had incomplete results from standard care.

Raymond Zakhari, DNP, Ed.M., ANP-BC, FNP-BC, PMHNP-BC, is a triple board-certified nurse practitioner with long-standing experience in psychiatry, primary care, geriatrics, and addiction. Collaborative communication with referring clinicians is standard when clinically appropriate and permitted by the patient.

Raymond Zakhari

DNP, Ed.M., ANP-BC, FNP-BC, PMHNP-BC

Triple board-certified nurse practitioner in adult, family, and psychiatric-mental health practice

Psychiatry · Primary care · Geriatrics
Addiction · Emergency & critical care
Medically complex inpatient settings
House call and concierge care

Founder

Metro Medical Direct & Psychiatry House Calls

Appropriate Referrals

Cases that fit this practice well

This practice is well suited to cases where access, privacy, clinical complexity, or a combination of these factors makes standard referrals difficult.

Older adults with cognitive or behavioral complexity

Patients with cognitive decline, dementia, delirium, behavioral changes, or complex medication regimens who need a thorough psychiatric evaluation — especially when house calls are appropriate or necessary.

Medical-psychiatric overlap

Patients whose psychiatric symptoms may be caused or complicated by medical illness, medication effects, metabolic issues, or other physiological factors that standard outpatient psychiatry has not fully addressed.

Privacy-sensitive cases

High-profile patients, executives, professionals, or anyone whose circumstances require care that does not route through large systems, insurance networks, or shared platforms.

High-functioning adults with burnout or decline

Professionals and executives who are experiencing burnout, mood changes, focus decline, or behavioral patterns affecting work or relationships — and who want a structured, private evaluation.

Young adults with failure-to-launch patterns

Emerging adults who remain stuck despite prior therapeutic work, or who have not responded to standard outpatient approaches. Appropriate for family-referred or self-referred cases.

Gambling, compulsive sexual behavior, or recurring relapse

Patients with addictive or compulsive behavioral patterns who have had incomplete results from prior treatment — including gambling disorder, compulsive sexual behavior, pornography-related patterns, and relapse cycles.

Patients who benefit from home visits

Patients who cannot easily leave their residence due to age, illness, anxiety, or other factors — including patients in assisted living, post-acute care, or homebound settings in Manhattan.

Sexual health concerns

Patients with desire, performance, or compulsive sexual behavior concerns that benefit from a clinician who integrates psychiatric, psychotherapeutic, and medical perspectives in a single relationship.

Practice Strengths

What this practice does well

Broad clinical background

Psychiatry, primary care, geriatrics, addiction, emergency and critical care, and medically complex inpatient settings — allowing a more complete evaluation when the picture is unclear.

House calls & concierge access

Available throughout Manhattan for appropriate cases. Useful for geriatric patients, post-acute situations, homebound patients, and cases where office attendance is a barrier.

Direct-pay structure

No insurance involvement, no shared systems. Designed for patients who value privacy and direct access, and who are willing to pay out-of-pocket for that model.

Strong medication and diagnostic reasoning

Psychopharmacological depth combined with broad medical knowledge — particularly relevant for cases involving medication side effects, polypharmacy, or overlapping medical and psychiatric illness.

IAP-informed pattern thinking

A clinical framework for understanding compulsive and addictive behaviors as reinforced patterns — relevant for gambling, compulsive sexual behavior, and relapse-prone presentations.

Collaborative communication

Communication with referring clinicians — including care managers, internists, therapists, and elder care professionals — is part of the care model when appropriate and consented by the patient.

Referral Process

How to refer a patient

The best first step is a direct phone conversation to discuss the case and determine fit. Patients may also self-refer directly using the contact form on this site.

Contact us to discuss the case

Use the contact form or request a call to discuss the clinical picture, the specific referral question, and whether this practice is an appropriate fit. A brief conversation is usually sufficient to determine fit.

Patient contacts us directly

Once the referral has been discussed, the patient (or family member, if appropriate) contacts the practice directly using the contact form or by requesting a confidential call. The patient is the primary contact for scheduling.

Collaborative communication after intake

Once care is underway, collaborative communication with the referring clinician is available when clinically appropriate and authorized by the patient in writing.

3×

Board certified — adult, family & psychiatric-mental health

NYC

Manhattan house calls + 1115 Broadway office

$800

Per visit · All visit types · No insurance billed

Direct

Access — no large system routing

Discuss a potential referral

If you have a patient who may benefit from this type of care, the best starting point is a brief conversation. Use the contact form or button below to reach out.