Active NPI
Marie Brunette Damis-Moise, NP
- Family Nurse Practitioner
- Brooklyn, NY
National Provider Identifier
1043593700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 336128
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03918265 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| F336128-1 | NY | MD | Nurse Practitioner |
| 336128 | NY | MD | Family Nurse Practitioner |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brownsville Community Development Corporation | Current | Accepting new patients | |
| Brownsville Community Development Corporation | Current | Accepting new patients | |
| Brownsville Community Development Corporation | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Brooklyn, NY
- NPI 1578612412
NY
-
- Federally Qualified Health Center (FQHC)
- Brooklyn, NY
- NPI 1275722340
-
- Urgent Care Clinic/Center
- Brooklyn, NY
- NPI 1316681430
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.