Individual provider Active NPI

Brendan P Cooper

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1073864716
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
088004 Issued in NY
Practice address
2300 East Ave Ste 1
Rochester, NY 14610-2566
Phone
(585) 310-8988
Fax
(585) 504-7183
NPI assigned
Sep 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 088004 NY Primary

Addresses

Primary practice location

2300 East Ave Ste 1
Rochester, NY 14610-2566

Mailing address

2300 East Ave Ste 1
Rochester, NY 14610-2566
Phone (585) 310-8988

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116001624 NY Practitioner - Clinical Social Worker 0042645269 Practice locations: Rochester, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2300 E Ave
Suite 18
Rochester, NY 14610-2564
Phone (585) 310-8988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1073864716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 EAST AVE STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146102566",
            "telephone_number": "585-310-8988",
            "fax_number": "585-504-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 EAST AVE STE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146102566",
            "telephone_number": "585-310-8988",
            "fax_number": "585-504-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BRENDAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.