Individual provider Active NPI

Brian G. Cole, M.D., M.PH.

  • Internal Medicine Physician
  • Broad Top, PA
National Provider Identifier
1184678955
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
223347 Issued in MA
Practice address
4133 Medical Center Dr
Broad Top, PA 16621-9001
Phone
(814) 635-2916
Fax
(814) 635-2918
NPI assigned
May 19, 2006
Last updated
Feb 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 223347 MA Primary

Addresses

Primary practice location

4133 Medical Center Dr
Broad Top, PA 16621-9001

Mailing address

4133 Medical Center Dr
Broad Top, PA 16621-9001
Phone (814) 635-2916

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
I20170112001216 NY Practitioner - Internal Medicine 5496646655 Reassigns benefits to 4 organizations
Practice locations: New Hyde Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prominis Medical Services PCGroup PAC ID 9537124441, 43 clinicians

Practice addresses (Care Compare)

10837 71St Ave
Suite 2
Forest Hills, NY 11375-4510
Phone (718) 575-8787

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223347MAMDInternal Medicine Physician
11150HIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Heights Health Center, Inc. CurrentSince May 7, 2018 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince May 7, 2018 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Nov 20, 2018 Accepting new patients
St Regis Mohawk Tribe CurrentSince Nov 1, 2016 Accepting new patients
Broad Top Area Medical Center, Inc PastSince May 25, 2021 Accepting new patients
Pinecroft Medical Center Past Accepting new patients
Tyrone Medical Associates Specs Past Accepting new patients

Locations

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

404 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141

412 State Route 37
Hogansburg, NY 13655
Phone (518) 358-3141

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Interoperability endpoints

  • Direct secure messaging: brian.cole.p1@direct.ezramedical.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1184678955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "BRIAN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D., M.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "223347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broad Top, PA

Sources for this page

Verify at the official NPI Registry.