Individual provider Active NPI

Bonnie Jean Brown, D.O.

  • Hospitalist Physician
  • Brooklyn, NY
National Provider Identifier
1346504453
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
286491 Issued in NY
Practice address
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone
(718) 270-1000
NPI assigned
Jul 3, 2012
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 286491 NY
Hospitalist Physician 208M00000X 286491 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1000

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
I20170525001582 NY Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Emergency Medicine 5193092039 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware River Medicine PLLCGroup PAC ID 4981034550, 30 clinicians

Practice addresses (Care Compare)

160 E Main St
Port Jervis, NY 12771-2253
Phone (845) 858-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286491NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2017 Accepting new patients
Delaware River Medicine, PLLC Hospitalist CurrentSince Dec 1, 2022 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Aug 6, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 6, 2017 Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2017 Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

15 Maple Ave
Warwick, NY 10990
Phone (845) 986-2224

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1346504453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "286491",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "286491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.