Individual provider Active NPI

Brandon Robert Smith

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1174880462
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
282921 Issued in NY
Practice address
2384 Atlantic Ave
Brooklyn, NY 11233-3402
Phone
(888) 425-0501
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 282921 NY Primary

Addresses

Primary practice location

2384 Atlantic Ave
Brooklyn, NY 11233-3402

Mailing address

7901 Broadway
D1-04
Elmhurst, NY 11373-1329
Phone (718) 334-3314

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180507000345 NY Practitioner - Psychiatry 9537450739 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282921NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Nov 3, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Psychiatry CurrentSince Mar 28, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 30, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Nov 3, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Psychiatry CurrentSince Mar 28, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 30, 2020 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

Organizations & group practices 8

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1174880462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "address_2": "D1-04",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3314",
            "fax_number": "718-334-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333402",
            "telephone_number": "888-425-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANDON",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "282921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.