Individual provider Active NPI

Bradley M Fischman

  • Prosthodontics
  • Great Neck, NY
National Provider Identifier
1417039421
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
028787 Issued in NY
Practice address
233 E Shore Rd
Suite 110
Great Neck, NY 11023-2433
Phone
(516) 482-5924
Fax
(888) 311-9754
NPI assigned
Oct 19, 2006
Last updated
Jul 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 028787 NY Primary

Addresses

Primary practice location

233 E Shore Rd
Suite 110
Great Neck, NY 11023-2433

Mailing address

233 E Shore Rd
Suite 110
Great Neck, NY 11023-2433
Phone (516) 482-5924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111219000700 NY Practitioner - Oral SurgeryPractitioner - Other (Physician) 6800091174 Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028787NYMDProsthodontist

Interoperability endpoints

  • Direct secure messaging: bfischman45138@direct.medisys.org

Organizations & group practices 1

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1417039421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E SHORE RD",
            "address_2": "SUITE 110",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232433",
            "telephone_number": "516-482-5924",
            "fax_number": "888-311-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E SHORE RD",
            "address_2": "SUITE 110",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232433",
            "telephone_number": "516-482-5924",
            "fax_number": "888-311-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHMAN",
        "first_name": "BRADLEY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "028787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.