Individual provider Active NPI

Denise Georgette Robinson, M.D.

  • Pediatrics Physician
  • Freeport, NY
National Provider Identifier
1336167907
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
137495 Issued in NY
Practice address
127 W Seaman Ave
Freeport, NY 11520-1545
Phone
(516) 379-0415
Fax
(516) 379-2516
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

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
Pediatrics Physician 208000000X 137495 NY Primary

Addresses

Primary practice location

127 W Seaman Ave
Freeport, NY 11520-1545

Mailing address

127 W Seaman Ave
Freeport, NY 11520-1545
Phone (516) 379-0415

Other identifiers 1

IdentifierTypeStateIssuer
479410MedicaidNY

Other names 1

  • Dr. Denise Georgette Brathwaite Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
137495NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336167907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W SEAMAN AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201545",
            "telephone_number": "516-379-0415",
            "fax_number": "516-379-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W SEAMAN AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201545",
            "telephone_number": "516-379-0415",
            "fax_number": "516-379-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "DENISE",
        "middle_name": "GEORGETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "137495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479410",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "BRATHWAITE",
            "middle_name": "GEORGETTE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.