Individual provider Active NPI

Carolyn Brockington, MD

  • Vascular Neurology Physician
  • New York, NY
National Provider Identifier
1427039551
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
203509 Issued in NY
Practice address
1000 10TH Ave
10TH Floor - Inn RM G64
New York, NY 10019-1147
Phone
(212) 636-3236
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2035091 NY
Vascular Neurology Physician 2084V0102X 203509 NY Primary

Addresses

Primary practice location

1000 10TH Ave
10TH Floor - Inn RM G64
New York, NY 10019-1147

Mailing address

PO Box 95000-2392
Philadelphia, PA 19195
Phone (212) 256-3539

Other identifiers 1

IdentifierTypeStateIssuer
02246573MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603001145 NY Practitioner - Neurology 6507848462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Albany Medical College of Union University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

1000 10TH Ave
New York, NY 10019-1147
Phone (212) 523-6521

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2035091NYMDNeurology Physician
203509NYMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Department of Neurology Professional Services Group/Slrhc Neurology Past Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

1000 10th Ave
Fl Inn
New York, NY 10019
Phone (212) 636-3236

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

150 E 42nd St
#5
New York, NY 10017
Phone (212) 523-5898

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1427039551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2392",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19195",
            "telephone_number": "212-256-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "address_2": "10TH FLOOR - INN RM G64",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-636-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKINGTON",
        "first_name": "CAROLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "2035091",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NY",
            "license": "203509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02246573",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.