Organization Active NPI

Jeremy a. Brauer, MD PC

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1417451865
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JEREMY A. BRAUER, MD PC
Practice address
1035 5TH Ave
New York, NY 10028-0135
Phone
(212) 288-8222
NPI assigned
Mar 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Authorized official

Name
Dr. Jeremy Alexander Brauer, MDNPI 1861667339
Title
Director
Phone
(914) 967-2153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X NY Primary

Addresses

Primary practice location

1035 5TH Ave
New York, NY 10028-0135

Mailing address

510 Oakhurst Rd
Mamaroneck, NY 10543-4003

Other practice location 1

175 Purchase St
Rye, NY 10580-2137
Phone (914) 967-2153

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210729001356 NY Part B Supplier - Clinic/Group Practice 1850794793 Receives reassigned benefits from 2 practitioners
Practice locations: Mamaroneck, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1417451865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 OAKHURST RD",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105434003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280135",
            "telephone_number": "212-288-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Purchase St",
            "address_purpose": "LOCATION",
            "city": "Rye",
            "state": "NY",
            "postal_code": "105802137",
            "country_code": "US",
            "telephone_number": "914-967-2153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEREMY A. BRAUER, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "BRAUER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "914-967-2153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.