NPIMap

Individual provider Active NPI

McKenzie Brubaker, FNP

  • Family Nurse Practitioner
  • Pulaski, NY
National Provider Identifier
1407690282
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354357 Issued in NY
Practice address
61 Delano St
Pulaski, NY 13142-1400
Phone
(315) 298-6564
Fax
(315) 298-3968
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 354357 NY Primary

Addresses

Primary practice location

61 Delano St
Pulaski, NY 13142-1400

Mailing address

61 Delano St
Pulaski, NY 13142-1400
Phone (315) 298-6564

Other practice location 1

510 S 4th St Ste 600
Fulton, NY 13069-2952
Phone (315) 598-4790

Other practice location 2

10 Carlton Dr
Parish, NY 13131-3308
Phone (315) 625-4388

Other practice location 3

7 Bridge St
Phoenix, NY 13135-1906
Phone (315) 695-4700

Other practice location 4

5856 Scenic Ave
Mexico, NY 13114-3012
Phone (315) 963-4133

Other practice location 5

3045 East Ave Ste G400
Central Square, NY 13036-2611
Phone (315) 675-9200

Other practice location 6

120 E 1st St
Oswego, NY 13126-2111
Phone (315) 342-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827002298 NY Practitioner - Nurse Practitioner 6103365762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Oswego County Health Services, Inc.Group PAC ID 8426961541, 37 clinicians

Practice addresses (Care Compare)

61 Delano St
Pulaski, NY 13142-1400
Phone (315) 298-6569

Hospital & facility affiliations

  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
354357NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Oswego County Health Services, Inc. CurrentSince Sep 9, 2024 Accepting new patients

Locations

3045 East Ave
Ste G400
Central Square, NY 13036
Phone (315) 675-9200

510 S 4th St
Ste 600
Fulton, NY 13069
Phone (315) 598-4790

5856 Scenic Ave
Mexico, NY 13114
Phone (315) 963-4133

120 E 1st St
Oswego, NY 13126
Phone (315) 342-0880

10 Carlton Dr
Parish, NY 13131
Phone (315) 625-4388

7 Bridge St
Phoenix, NY 13135
Phone (315) 695-4100

61 Delano St
Pulaski, NY 13142
Phone (315) 298-4274

Interoperability endpoints

  • Direct secure messaging: mckenzie.brubaker@nochsi.directbygreenway.com

Organizations & group practices 13

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

View all 13

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1407690282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6564",
            "fax_number": "315-298-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DELANO ST",
            "city": "PULASKI",
            "state": "NY",
            "postal_code": "131421400",
            "telephone_number": "315-298-6564",
            "fax_number": "315-298-3968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 S 4th St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Fulton",
            "state": "NY",
            "postal_code": "130692952",
            "country_code": "US",
            "telephone_number": "315-598-4790",
            "fax_number": "315-593-6195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Carlton Dr",
            "address_purpose": "LOCATION",
            "city": "Parish",
            "state": "NY",
            "postal_code": "131313308",
            "country_code": "US",
            "telephone_number": "315-625-4388",
            "fax_number": "315-625-4535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Bridge St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "NY",
            "postal_code": "131351906",
            "country_code": "US",
            "telephone_number": "315-695-4700",
            "fax_number": "315-695-4706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5856 Scenic Ave",
            "address_purpose": "LOCATION",
            "city": "Mexico",
            "state": "NY",
            "postal_code": "131143012",
            "country_code": "US",
            "telephone_number": "315-963-4133",
            "fax_number": "315-963-4960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3045 East Ave Ste G400",
            "address_purpose": "LOCATION",
            "city": "Central Square",
            "state": "NY",
            "postal_code": "130362611",
            "country_code": "US",
            "telephone_number": "315-675-9200",
            "fax_number": "315-630-3168",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "NY",
            "postal_code": "131262111",
            "country_code": "US",
            "telephone_number": "315-342-0880",
            "fax_number": "315-593-6195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "MCKENZIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, NY

Sources for this page

Verify at the official NPI Registry.