Individual provider Active NPI

Brenda T Gorman

  • Specialist
  • Hawthorne, NY
National Provider Identifier
1245093962
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
738723 Issued in NY
Practice address
15 Skyline Dr
Hawthorne, NY 10532-2152
Phone
(914) 347-5990
Fax
(914) 347-5236
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 738723 NY Primary

Addresses

Primary practice location

15 Skyline Dr
Hawthorne, NY 10532-2152

Mailing address

7 Jordan LN
Ardsley, NY 10502-1313
Phone (917) 806-4780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
738723NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Alexa Reynoso-Jimenez Specialist CurrentSince Oct 21, 2025 Accepting new patients
Los Ninos Private Services PastSince Feb 11, 2024 Accepting new patients

Locations

15 Skyline Dr
Hawthorne, NY 10532
Phone (914) 347-5990

Organizations & group practices 2

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1245093962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 JORDAN LN",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105021313",
            "telephone_number": "917-806-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SKYLINE DR",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322152",
            "telephone_number": "914-347-5990",
            "fax_number": "914-347-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "BRENDA",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "738723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.