Ira Brenner, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD022052E Issued in PA

Practice address

10 Presidential Blvd
Suite 116
Bala Cynwyd, PA 19004-1107

Phone

(610) 667-3183

Fax

(610) 667-4401

NPI assigned

Jan 26, 2009

Last updated

Jan 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2013 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1144468372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PRESIDENTIAL BLVD",
            "address_2": "SUITE 116",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041107",
            "telephone_number": "610-667-3183",
            "fax_number": "610-667-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PRESIDENTIAL BLVD",
            "address_2": "SUITE 116",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041107",
            "telephone_number": "610-667-3183",
            "fax_number": "610-667-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD022052E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Bralow, D.O.
• Kirk Brandow, MD
• Eliyahu Breiner, LSW
• Lauren E Brennan, PA-C
• Gail B Brenner, AU.D.
• Roberta K Brenner, L.C.S.W.
• Eddy Armin Bresnitz, MD
• Brian Gallagher Psy.D. LLC
• Brian Goldstein DPM
• Samirah N Bridgeford

• Psychiatry Physician in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.