Individual provider Active NPI

Brooke Maggy, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Plattsburgh, NY
National Provider Identifier
1073099172
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022093 Issued in NY
Practice address
23 Hammond LN
Plattsburgh, NY 12901-2000
Phone
(518) 561-1322
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022093 NY Primary

Addresses

Primary practice location

23 Hammond LN
Plattsburgh, NY 12901-2000

Mailing address

23 Hammond LN
Plattsburgh, NY 12901-2000

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
I20180828000430 NY Practitioner - Physician Assistant 0547519381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

206 Cornelia St
Plattsburgh, NY 12901-2779

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center Internal Medicine CurrentSince Jul 7, 2018 Accepting new patients

Locations

23 Hammond Ln
Plattsburgh, NY 12901
Phone (518) 561-1322

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

Interoperability endpoints

  • Direct secure messaging: bmaggy236515@direct.uvmhealth.org

Organizations & group practices 1

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1073099172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 HAMMOND LN",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 HAMMOND LN",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012000",
            "telephone_number": "518-561-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGY",
        "first_name": "BROOKE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.