Individual provider Active NPI

Dawn P Brauer, M.S.P.T., C.I.M.I.

  • Physical Therapist
  • Lake Grove, NY
National Provider Identifier
1417094608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
019793 Issued in NY
Practice address
7 Briarberry CT
Lake Grove, NY 11755-2232
Phone
(631) 431-6824
Fax
(631) 580-5378
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 019793 NY Primary

Addresses

Primary practice location

7 Briarberry CT
Lake Grove, NY 11755-2232

Mailing address

7 Briarberry CT
Lake Grove, NY 11755-2232
Phone (631) 431-6824

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019793NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dawn P. Brauer PT PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417094608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BRIARBERRY CT",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552232",
            "telephone_number": "631-431-6824",
            "fax_number": "631-580-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BRIARBERRY CT",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552232",
            "telephone_number": "631-431-6824",
            "fax_number": "631-580-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUER",
        "first_name": "DAWN",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "M.S.P.T., C.I.M.I.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "019793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.