Individual provider Active NPI

Brandiss T Pearson, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1255586046
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341818 Issued in NY
Practice address
819 S Salina St
Syracuse, NY 13202-3527
Phone
(315) 476-7921
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 277056 NY
Family Nurse Practitioner 363LF0000X 341818 NY Primary

Addresses

Primary practice location

819 S Salina St
Syracuse, NY 13202-3527

Mailing address

722 W Manlius St
East Syracuse, NY 13057-2158
Phone (315) 437-7091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA, TX3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220317001097 NY Practitioner - Nurse Practitioner 6901145432 Reassigns benefits to 1 organization
I20250429003164 GA Practitioner - Nurse Practitioner 6901145432
I20260519002022 TX Practitioner - Nurse Practitioner 6901145432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 400
Dallas, TX 75244-4910

4055 Valley View LN
Suite 400
Dallas, TX 75244-5071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aim Healthcare Providers Ga, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bpearson1@hiemail.healtheconnections.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255586046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 W MANLIUS ST",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130572158",
            "telephone_number": "315-437-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023527",
            "telephone_number": "315-476-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "BRANDISS",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "277056",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.