Individual provider Active NPI

Kristyn M Brandi, MD MPH

  • Obstetrics & Gynecology Physician
  • Newark, NJ
National Provider Identifier
1356630107
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA10306500 Issued in NJ
Practice address
140 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-2700
NPI assigned
Apr 1, 2011
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 261802 MA
Obstetrics & Gynecology Physician 207V00000X 25MA10306500 NJ Primary

Addresses

Primary practice location

140 Bergen St
Newark, NJ 07103-2425

Mailing address

30 Bergen St RM 1205
Newark, NJ 07107-3000

Other identifiers 1

IdentifierTypeStateIssuer
0647063MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbrandi1207@direct-uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180809005740 NJ Practitioner - Obstetrics/Gynecology 3375858392 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10306500NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Sep 1, 2018 Accepting new patients
University Physician Associates of New Jersey Inc Obstetrics & Gynecology CurrentSince Sep 1, 2018 Accepting new patients

Locations

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

Interoperability endpoints

  • Direct secure messaging: kristyn.brandimd.p1@direct.plannedparenthoodla.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1356630107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST RM 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDI",
        "first_name": "KRISTYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "261802",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA10306500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0647063",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbrandi1207@direct-uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "EPIC",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.