Individual provider Active NPI

Brandon Reid Cooper, D.C.

  • Chiropractor
  • New York, NY
National Provider Identifier
1407814817
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010898 Issued in NY
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, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02623509MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101000827 NY Practitioner - Chiropractic 4789646894 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
X010898NYMDChiropractor
010898NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.