Active NPI
Robert J Brenner, MD
- Ophthalmology Physician
- New City, NY
National Provider Identifier
1407954878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 116414
- Practice address
- 365 S Main St
New City, NY 10956-3061 - Phone
- (845) 634-2900
- Fax
- (845) 634-3066
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 116414 | NY | Primary |
Addresses
Primary practice location
365 S Main St
New City, NY 10956-3061
Mailing address
365 S Main St
New City, NY 10956-3061
Phone (845) 634-2900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116414 | NY | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1407954878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 S MAIN ST",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109563061",
"telephone_number": "845-634-2900",
"fax_number": "845-634-3066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 S MAIN ST",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109563061",
"telephone_number": "845-634-2900",
"fax_number": "845-634-3066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "116414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.