Individual provider Active NPI

Maria T Bromley, PA

  • Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1023174968
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008751 Issued in NY
Practice address
45 Reade PL
Department of Neonatology
Poughkeepsie, NY 12601-3947
Phone
(845) 431-5677
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001856 CT
Physician Assistant 363A00000X 008751 NY Primary

Addresses

Primary practice location

45 Reade PL
Department of Neonatology
Poughkeepsie, NY 12601-3947

Mailing address

21 Stonewall Farm Rd
Mahopac, NY 10541-2620
Phone (845) 208-3542

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227002043 NY Practitioner - Physician Assistant 8820190556 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008751NYMDMental Health Counselor
001856CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 14, 2019 Accepting new patients
New York University CurrentSince Jan 14, 2019 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: mbromley112338@nyumc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1023174968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 STONEWALL FARM RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412620",
            "telephone_number": "845-208-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "address_2": "DEPARTMENT OF NEONATOLOGY",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-431-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "MARIA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001856",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.