Mark Brennan, DO

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

217717 Issued in NY

Practice address

30 Harrison St
Ste 455
Johnson City, NY 13790-2161

Phone

(607) 763-8100

Fax

(607) 763-8048

NPI assigned

Jul 28, 2005

Last updated

Sep 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Vascular Surgery

Education

Philadelphia College of Osteopathic Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Health Services Hospitals, Inc.Group PAC ID 5193610533, 471 clinicians

Chenango Memorial Hospital IncGroup PAC ID 7517853633, 108 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

Merit-based Incentive Payment System (MIPS)

Final score

96.41 of 100Reported as group

Quality

90.71

Promoting interoperability

99

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

89.14 of 100Reported as group

Quality

86.74

Promoting interoperability

99

Improvement activities

40

Cost

70.09

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1127.epichosted.com/FHIRproxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chenango Memorial Hospital Inc

  • General Acute Care Hospital
  • Norwich, NY
  • NPI 1770593956
  Medicare reassignment Care Compare group NPD
• United Health Services Hospitals, Inc.

  • Multi-Specialty Clinic/Center
  • Johnson City, NY
  • NPI 1962463851
  Medicare reassignment Care Compare group NPD
• Chenango Memorial Hospital Inc

  • Durable Medical Equipment & Medical Supplies
  • Norwich, NY
  • NPI 1437818622
  NPD
• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889

  Surgery

  NPD
• United Health Services Hospitals, Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1518998699
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• United Health Services Hospitals, Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1518998699
  Care Compare affiliation

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1174523443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "address_2": "UNITED MEDICAL ASSOCIATES, PC",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902558",
            "telephone_number": "607-763-8100",
            "fax_number": "607-729-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "address_2": "STE 455",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902161",
            "telephone_number": "607-763-8100",
            "fax_number": "607-763-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "217717",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "217717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02082319",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Frederic Bowersox, LMSW
• Susan Boyko
• Cariann Susan Brady, FNP
• Jennifer M Branish, CRNA
• Jillene Myrnelle Brathwaite, D.O.
• Christine B. Breslin, RN
• Gregory J Bretz, PA
• Diana L Brewer, MS, CCC-SLP
• Aaron Bridgemohan
• Tyson Don Brierley, D.O.

• Vascular Surgery Physician in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.