Individual provider Active NPI

Michael H Brisman, M.D.

  • Specialist
  • Rockville Centre, NY
National Provider Identifier
1255355475
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
194149-1 Issued in NY
Practice address
100 Merrick Rd
Suite 128 W
Rockville Centre, NY 11570-4800
Phone
(516) 255-9031
Fax
(516) 255-6230
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 194149-1 NY Primary

Addresses

Primary practice location

100 Merrick Rd
Suite 128 W
Rockville Centre, NY 11570-4800

Mailing address

100 Merrick Rd
Suite 128 W
Rockville Centre, NY 11570-4800
Phone (516) 255-9031

Other identifiers 1

IdentifierTypeStateIssuer
01827274MedicaidNY

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
I20070601000444 NY Practitioner - Neurosurgery 9638104219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Columbia University College of Physicians and Surgeons, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurological Surgery Practice of Long Island PLLCGroup PAC ID 0345131785, 14 clinicians

Practice addresses (Care Compare)

100 Merrick Rd
128W
Rockville Centre, NY 11570-4821
Phone 516442346110

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
194149-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Surgery Practice of Long Island PLLC Specialist CurrentSince Jan 1, 1995 Accepting new patients
NYU Langone Hospitals Past Accepting new patients
NSPC Plastics PastSince Jan 1, 1995 Accepting new patients

Locations

600 Northern Blvd
Ste 117
Great Neck, NY 11021
Phone (516) 442-3461

100 Merrick Rd
Ste 128W
Rockville Ctr, NY 11570
Phone (516) 255-9031

100 Merrick Rd
Ste 100W
Rockville Ctr, NY 11570
Phone (516) 632-7050

500 Montauk Hwy
Ste K
West Islip, NY 11795
Phone (252) 903-8657

Organizations & group practices 3

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 8

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255355475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MERRICK RD",
            "address_2": "SUITE 128 W",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704800",
            "telephone_number": "516-255-9031",
            "fax_number": "516-255-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERRICK RD",
            "address_2": "SUITE 128 W",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704800",
            "telephone_number": "516-255-9031",
            "fax_number": "516-255-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISMAN",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "194149-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01827274",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.