Active NPI
Brandon Reid Cooper, D.C.
- Chiropractor
- New York, NY
National Provider Identifier
1407814817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X010898
- Practice address
- 450 Park Ave S
Suite 2B
New York, NY 10016-7320 - Phone
- (212) 679-4233
- Fax
- (212) 679-4234
- NPI assigned
- May 3, 2006
- Last updated
- May 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X010898 | NY | Primary |
Addresses
Primary practice location
450 Park Ave S
Suite 2B
New York, NY 10016-7320
Mailing address
450 Park Ave S
Suite 2B
New York, NY 10016-7320
Phone (212) 679-4233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02623509 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
36 W 44TH St
Suite 610
New York, NY 10036-8105
Phone (646) 941-5061
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X010898 | NY | MD | Chiropractor |
| 010898 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooper Chiropractic & Wellness Center | Chiropractor | Past | Accepting new patients |
| Cooper Wellness and Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1407814817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 PARK AVE S",
"address_2": "SUITE 2B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100167320",
"telephone_number": "212-679-4233",
"fax_number": "212-679-4234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 PARK AVE S",
"address_2": "SUITE 2B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100167320",
"telephone_number": "212-679-4233",
"fax_number": "212-679-4234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "BRANDON",
"middle_name": "REID",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X010898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02623509",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.