Individual provider Active NPI

Daniel Edward Brezina, MD

  • Anesthesiology Physician
  • Stony Brook, NY
National Provider Identifier
1073803441
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
57151 Issued in TN
Practice address
100 Nicolls Road
Stony Brook Medical Center, Dept. of Anesthesiology
Stony Brook, NY 11794-8480
Phone
(631) 444-2975
Fax
(631) 444-2907
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 57151 TN Primary

Addresses

Primary practice location

100 Nicolls Road
Stony Brook Medical Center, Dept. of Anesthesiology
Stony Brook, NY 11794-8480

Mailing address

100 Nicolls Road
Stony Brook Medical Center, Dept. of Anesthesiology
Stony Brook, NY 11794-8480
Phone (631) 444-2975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20180905001288 TN Practitioner - Anesthesiology 3072809409 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesiologists P a Anesthesiology CurrentSince Apr 1, 2018 Accepting new patients

Locations

786 Estate Pl
Memphis, TN 38120
Phone (901) 287-4100

50 N Dunlap St
Memphis, TN 38103
Phone (901) 522-3060

Interoperability endpoints

  • Direct secure messaging: dbrezina24913@mlh.direct-ci.com

Organizations & group practices 2

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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1073803441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS ROAD",
            "address_2": "STONY BROOK MEDICAL CENTER, DEPT. OF ANESTHESIOLOGY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948480",
            "telephone_number": "631-444-2975",
            "fax_number": "631-444-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS ROAD",
            "address_2": "STONY BROOK MEDICAL CENTER, DEPT. OF ANESTHESIOLOGY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948480",
            "telephone_number": "631-444-2975",
            "fax_number": "631-444-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREZINA",
        "first_name": "DANIEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "57151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.