Organization Active NPI

Robert J Brown Jr Rpa PC

  • Medical Physician Assistant
  • Manhasset, NY
National Provider Identifier
1396395380
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
ROBERT J BROWN JR RPA PC
Practice address
1165 Northern Blvd Ste 400
Manhasset, NY 11030-3048
Phone
(516) 352-8880
NPI assigned
Sep 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
Robert Justin Brown Jr., PANPI 1699008458
Title
Authorized Official/ Owner
Phone
(631) 742-0565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

1165 Northern Blvd Ste 400
Manhasset, NY 11030-3048

Mailing address

24 Hamilton SQ
Glen Head, NY 11545-1519
Phone (516) 352-8880

Other names 1

  • Robert J Brown JR RPA PC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230209003011 NY Part B Supplier - Clinic/Group Practice 9739551250 Receives reassigned benefits from 3 practitioners
Practice locations: Manhasset, NY

National Provider Directory

National Provider Directory

Locations

1165 Northern Blvd
Ste 400
Manhasset, NY 11030
Phone (516) 499-3964

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1396395380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HAMILTON SQ",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451519",
            "telephone_number": "516-352-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 NORTHERN BLVD STE 400",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303048",
            "telephone_number": "516-352-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J BROWN JR RPA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/ OWNER",
        "authorized_official_telephone_number": "631-742-0565",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert J Brown JR RPA PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Robert J Brown JR RPA PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.