John R. Brereton, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

131008 Issued in NY

Practice address

179 N Broad St
Norwich, NY 13815-1019

Phone

(607) 337-4215

Fax

(607) 337-4102

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• State of New York Comptrollers Office

  • Skilled Nursing Facility
  • Oxford, NY
  • NPI 1386851004
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1407937469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 N BROAD ST",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151019",
            "telephone_number": "607-337-4215",
            "fax_number": "607-337-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 N BROAD ST",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138151019",
            "telephone_number": "607-337-4215",
            "fax_number": "607-337-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRERETON",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "131008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131008",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00582729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Boudreau, MD
• Kristen M Bradbury
• Sarah Brady
• Michael P Branigan, C.R.N.A.
• Lynne R Brazee, OTR/L
• Vladimir F. Breslau, DO, PHD
• Gayle L Breuilly, RD
• Paige Brigham, LCSW
• Anne Elizabeth Brightsen, LCSW-R
• Cynthia A Briglin-Mavady, M.D.

• Cardiovascular Disease Physician in Norwich, NY
• Providers in Norwich, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.