Individual provider Active NPI

Bryann Bromley, M.D.

  • Diagnostic Radiology Physician
  • Brookline, MA
National Provider Identifier
1104825959
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
56429 Issued in MA
Practice address
1 Brookline PL
Suite 506
Brookline, MA 02445-7224
Phone
(617) 739-0245
Fax
(617) 738-6703
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 56429 MA Primary
Maternal & Fetal Medicine Physician 207VM0101X 56429 MA

Addresses

Primary practice location

1 Brookline PL
Suite 506
Brookline, MA 02445-7224

Mailing address

340 Main St
Ste. 670
Worcester, MA 01608-1604
Phone (617) 724-2229

Other identifiers 1

IdentifierTypeStateIssuer
3020304MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040819001138 MA Practitioner - Obstetrics/Gynecology 7719951425 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Ultrasound Associates, PCGroup PAC ID 1951485507, 4 clinicians
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

1 Brookline PL
Suite 506
Brookline, MA 02445-7277
Phone (617) 739-0245

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56429MAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Ultrasound Associates, PC Diagnostic Radiology CurrentSince Apr 1, 1987 Accepting new patients
The General Hospital Corporation CurrentSince Oct 11, 2012 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Apr 1, 1987 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#10
Boston, MA 02114
Phone 61772467006735

1 Brookline Pl
Ste 506
Brookline, MA 02445
Phone (617) 735-8660

Interoperability endpoints

  • Direct secure messaging: bromley.bryann.mgh@direct.partners.masshiway.net

Organizations & group practices 4

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1104825959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAIN ST",
            "address_2": "STE. 670",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081604",
            "telephone_number": "617-724-2229",
            "fax_number": "617-724-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PL",
            "address_2": "SUITE 506",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457224",
            "telephone_number": "617-739-0245",
            "fax_number": "617-738-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "BRYANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "56429",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MA",
            "license": "56429",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020304",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.