Individual provider Active NPI

Mary Margaret Kane-Brock, MD

  • Internal Medicine Physician
  • Greenwich, CT
National Provider Identifier
1245312305
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
035005 Issued in CT
Practice address
75 Holly Hill LN
Greenwich, CT 06830-6098
Phone
(203) 869-6960
Fax
(203) 869-5103
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 035005 CT
Internal Medicine Physician 207R00000X 035005 CT Primary

Addresses

Primary practice location

75 Holly Hill LN
Greenwich, CT 06830-6098

Mailing address

75 Holly Hill LN
Greenwich, CT 06830-6098
Phone (203) 869-6960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20060411000024 CT Practitioner - Endocrinology 7315956943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

5 Perryridge Rd
Greenwich, CT 06830-4608
Phone (203) 863-3840

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035005CTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwich Hospital CurrentSince Jul 23, 2019 Accepting new patients
Greenwich Hospital CurrentSince Jul 23, 2019 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Apr 1, 2010 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Apr 1, 2010 Accepting new patients

Locations

226 Mill Hill Ave
Bridgeport, CT 06610
Phone (203) 384-3235

75 Holly Hill Ln
Greenwich, CT 06830
Phone (203) 661-3333

49 Lake Ave
Greenwich, CT 06830
Phone (203) 661-9383

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: mkanebrock6432@direct.ynhh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1245312305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HOLLY HILL LN",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306098",
            "telephone_number": "203-869-6960",
            "fax_number": "203-869-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HOLLY HILL LN",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306098",
            "telephone_number": "203-869-6960",
            "fax_number": "203-869-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE-BROCK",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "035005",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "035005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.