Individual provider Active NPI

Marie Brunette Damis-Moise, NP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1043593700
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336128 Issued in NY
Practice address
400 Pennsylvania Ave
Brooklyn, NY 11207-4707
Phone
(718) 345-5000
Fax
(347) 875-1009
NPI assigned
Sep 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 336128 NY Primary
Nurse Practitioner 363L00000X F336128-1 NY

Addresses

Primary practice location

400 Pennsylvania Ave
Brooklyn, NY 11207-4707

Mailing address

592 Rockaway Ave
Brooklyn, NY 11212-5539
Phone (718) 345-5000

Other identifiers 1

IdentifierTypeStateIssuer
03918265MedicaidNY

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
I20190408001911 NY Practitioner - Nurse Practitioner 2961743513 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F336128-1NYMDNurse Practitioner
336128NYMDFamily Nurse Practitioner

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Brownsville Community Development Corporation CurrentSince Feb 27, 2019 Accepting new patients
Brownsville Community Development Corporation CurrentSince Dec 7, 2025 Accepting new patients
Brownsville Community Development Corporation CurrentSince Feb 27, 2019 Accepting new patients

Locations

592 Rockaway Ave
Brooklyn, NY 11212
Phone (718) 345-5000

400 Pennsylvania Ave
Brooklyn, NY 11207
Phone (718) 345-5000

Networks

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

Interoperability endpoints

  • Direct secure messaging: marie.damis-moise.1@13126.direct.athenahealth.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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1043593700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 ROCKAWAY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125539",
            "telephone_number": "718-345-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112074707",
            "telephone_number": "718-345-5000",
            "fax_number": "347-875-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIS-MOISE",
        "first_name": "MARIE",
        "middle_name": "BRUNETTE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336128",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F336128-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03918265",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.