Individual provider Active NPI

Braden James Hexom, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1063671634
Registry record updated Jun 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
242307 Issued in NY
Practice address
1 Gustave L Levy PL # 1149
New York, NY 10029-6500
Phone
(212) 241-0763
NPI assigned
Jun 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 242307 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL # 1149
New York, NY 10029-6500

Mailing address

1 Gustave L Levy PL # 1149
New York, NY 10029-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160621002185 IL Practitioner - Emergency Medicine 2365592458 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeport Memorial HospitalGroup PAC ID 8426958232, 168 clinicians
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

1653 W Congress Pkwy
Chicago, IL 60612-3833

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Rush Oak Park ER Physicians Group CurrentSince Jun 1, 2021 Accepting new patients
Freeport Memorial Hospital CurrentSince Mar 25, 2017 Accepting new patients
Mount Sinai School of Medicine Emergency Medicine Past Accepting new patients

Locations

75 Remittance Dr
Dept 1620
Chicago, IL 60675

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
#177
Chicago, IL 60612
Phone (312) 947-0229

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

421 W Exchange St
Freeport, IL 61032
Phone (815) 599-7300

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Interoperability endpoints

  • Direct secure messaging: bhexom127274@direct.rush.rush-health.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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212883200000",
    "number": "1063671634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEXOM",
        "first_name": "BRADEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-08",
        "last_updated": "2008-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "242307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.