NPIMap

Individual provider Active NPI

Matthew Metcalf Brockway, MD

  • Internal Medicine Physician
  • Penfield, NY
National Provider Identifier
1003251976
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
284532 Issued in NY
Practice address
2212 Penfield Rd Ste 200
Penfield, NY 14526-1756
Phone
(585) 598-8565
Fax
(585) 388-0174
NPI assigned
May 6, 2013
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 284532 NY Primary

Addresses

Primary practice location

2212 Penfield Rd Ste 200
Penfield, NY 14526-1756

Mailing address

2212 Penfield Rd Ste 200
Penfield, NY 14526-1756
Phone (585) 598-8565

Other identifiers 1

IdentifierTypeStateIssuer
04451061MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mbrockway45526@direct.urmc.rochester.edu Direct
Direct Messaging Address mbrockway45526@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160726001649 NY Practitioner - Internal Medicine 0648563841 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284532NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Group CurrentSince Jun 24, 2016 Accepting new patients
Highland Hospital of Rochester Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
University of Rochester CurrentSince Jun 24, 2016 Accepting new patients
Internal Medicine Group Internal Medicine CurrentSince Jun 24, 2016 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
University of Rochester Internal Medicine CurrentSince Jun 24, 2016 Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Highland Hospital of Rochester Current Accepting new patients
Highland Hospital of Rochester CurrentSince Jul 1, 2016 Accepting new patients

Locations

2212 Penfield Rd
Ste 200
Penfield, NY 14526
Phone (585) 598-8565

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

990 South Ave
Ste 207
Rochester, NY 14620
Phone (585) 341-6660

Interoperability endpoints

  • Direct secure messaging: mbrockway45526@direct.urmc.rochester.edu

Organizations & group practices 10

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1003251976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 PENFIELD RD STE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261756",
            "telephone_number": "585-598-8565",
            "fax_number": "585-388-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 PENFIELD RD STE 200",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261756",
            "telephone_number": "585-598-8565",
            "fax_number": "585-388-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "MATTHEW",
        "middle_name": "METCALF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "284532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04451061",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrockway45526@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrockway45526@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

Verify at the official NPI Registry.