Deidra G Brown, GNP-BC
Individual provider Active NPI Gerontology Nurse Practitioner · West Harrison, NY
NPI 1255880993 · NPPES record last updated Sep 22, 2016
Key facts
- NPI
- 1255880993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 340408 (NY)
- Practice address
- 51 Lincoln Ave E
West Harrison, NY 10604-2621 - Phone
- (914) 667-0279
- NPI assigned
- Sep 22, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Medical Care at Home PC
Practice addresses (Care Compare)
220 E 42ND St
FL 6
New York, NY 10017-5831
Phone (646) 453-6900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190508002534 | NY | Practitioner - Nurse Practitioner | 1052653201 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vytaliz Medical | Current |
Accepting new patients | |
| Medical Care at Home PC | Current |
Accepting new patients |
Locations
3 E Evergreen Rd
Ste 1017
New City, NY 10956
Phone (201) 565-2533
220 E 42nd St
Fl 6
New York, NY 10017
Phone (212) 609-9640
5065 Wooster Rd
Cincinnati, OH 45226
Interoperability endpoints
- deidra.brown.1@30409.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 340408 | NY | Yes |
Addresses
Primary practice location
51 Lincoln Ave E
West Harrison, NY 10604-2621
Mailing address
51 Lincoln Ave E
West Harrison, NY 10604-2621
Phone (914) 667-0279
Other providers in West Harrison, NY
- Nancy Blaine
- Lucy Akosua Boadu
- Stacey Ann Bonagura
- Linda C. Bond
- Kyle Brinkerhoff
- Karin Marie Budrock
- Anais Lynn Carniciu
- Philip Charles Cea
- Amber W Choudhry
- Peter Seon Chung
All providers in West Harrison, NY · Gerontology Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.