Individual provider Active NPI

Sheridan Brown, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1053841189
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F308610-1 Issued in NY
Practice address
245 5TH Ave FL 3
New York, NY 10016-8728
Phone
(917) 261-4414
Fax
(917) 261-4420
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F308610-1 NY Primary

Addresses

Primary practice location

245 5TH Ave FL 3
New York, NY 10016-8728

Mailing address

101 Greenwich St Ste 403
New York, NY 10006-1895
Phone (917) 261-4414

Other practice location 1

530 5th Ave
New York, NY 10036-5101
Phone (917) 261-4414

Other practice location 2

1501 S Clinton St
Baltimore, MD 21224-5730
Phone (917) 261-4414

Other practice location 3

80 Maiden Ln Ste 403
New York, NY 10038-4811
Phone (917) 261-4414

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
I20180807003044 NY Practitioner - Nurse Practitioner 8527316579 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Columbia University College of Physicians and Surgeons, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Community Health Initiatives, Inc.Group PAC ID 6709185408, 23 clinicians

Practice addresses (Care Compare)

1419 Mermaid Ave
Brooklyn, NY 11224-2615
Phone (718) 210-3110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F308610-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Initiatives, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 23, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 23, 2018 Accepting new patients
The Trustees of Columbia University in the City of New York Adult Health CurrentSince Jun 23, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 23, 2018 Accepting new patients

Locations

1419 Mermaid Ave
Brooklyn, NY 11224
Phone (718) 210-3110

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

622 W 168th St
#4100
New York, NY 10032
Phone (212) 305-5123

622 W 168th St
#14C
New York, NY 10032

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/cybermed_chi
  • Direct secure messaging: shb9172@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: sheridan.brown.1@24265.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1053841189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREENWICH ST STE 403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061895",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100365101",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 S Clinton St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212245730",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Maiden Ln Ste 403",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100384811",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHERIDAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308610-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.