Individual provider Active NPI

Lisa D. Brabham, MD

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1063455293
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
206007 Issued in NY
Practice address
760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206
Phone
(718) 963-8000
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 206007 NY Primary

Addresses

Primary practice location

760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206

Mailing address

760 Broadway Department of Managed Care Room 2B230
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206
Phone (718) 963-8000

Other identifiers 1

IdentifierTypeStateIssuer
01772898MedicaidNY

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
I20040423000671 NY Practitioner - Obstetrics/GynecologyPractitioner - General Practice 8820084858 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Aug 24, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Aug 24, 2021 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
Brookdale Family Care Center, Inc. Obstetrics & Gynecology Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

760 Broadway
Rm 2B230
Brooklyn, NY 11206

100 N Portland Ave
Brooklyn, NY 11205
Phone (718) 260-7500

760 Broadway
Brooklyn, NY 11206
Phone (718) 963-5807

50 Water St
Fl 3
New York, NY 10004

227 Madison St
New York, NY 10002
Phone (212) 238-7000

Networks

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

Interoperability endpoints

  • Direct secure messaging: lbrabham562917@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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1063455293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B230",
            "address_2": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "718-630-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABHAM",
        "first_name": "LISA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "206007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01772898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.