Individual provider Active NPI

Gabriel H Brandeis, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1023093994
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
166195 Issued in NY
Practice address
Medical Department
79-01 Broadway
New York, NY 11373
Phone
(718) 334-3444
Fax
(718) 334-2879
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58101 MA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 58101 MA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 166195 NY Primary

Addresses

Primary practice location

Medical Department
79-01 Broadway
New York, NY 11373

Mailing address

Medical Department
79-01 Broadway
New York, NY 11373
Phone (718) 334-3444

Other practice location 1

850 Harrison Ave
YACC, 3rd Floor
Boston, MA 02118-4001
Phone (617) 638-6100

Other practice location 2

850 Harrison Ave
YACC, 3rd Floor
Boston, MA 02118-4001
Phone (617) 638-6100

Other practice location 3

120 West 106th Street
Medical Department
New York, NY 10025
Phone (212) 870-5978

Other identifiers 2

IdentifierTypeStateIssuer
110049558AMedicaidMA
BG3AMedicaidNY

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
I20170215000536 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1254378110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Icahn School of Medicine at Mount Sinai, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 8224282926, 317 clinicians

Practice addresses (Care Compare)

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4952

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • Elmhurst Hospital Center Hospital, Elmhurst, NY, CCN 330128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58101MAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients
Evans Geriatric Section of Evans Geriatric Medicine PastSince Aug 1, 2018 Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: gbrandeis670444@nychhc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1023093994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL DEPARTMENT",
            "address_2": "79-01 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-334-3444",
            "fax_number": "718-334-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL DEPARTMENT",
            "address_2": "79-01 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-334-3444",
            "fax_number": "718-334-2879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Harrison Ave",
            "address_2": "YACC, 3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021184001",
            "country_code": "US",
            "telephone_number": "617-638-6100",
            "fax_number": "617-638-6179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Harrison Ave",
            "address_2": "YACC, 3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021184001",
            "country_code": "US",
            "telephone_number": "617-638-6100",
            "fax_number": "617-638-6179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 West 106th Street",
            "address_2": "Medical Department",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10025",
            "country_code": "US",
            "telephone_number": "212-870-5978",
            "fax_number": "212-870-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDEIS",
        "first_name": "GABRIEL",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "58101",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "58101",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "166195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110049558A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BG3A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.