Individual provider Active NPI

Brendan Patrick Dwyer, FNP

  • Primary Care Nurse Practitioner
  • Cobleskill, NY
National Provider Identifier
1457017485
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F348561-01 Issued in NY
Practice address
136 Parkway Dr
Cobleskill, NY 12043-5150
Phone
(518) 234-2555
NPI assigned
Nov 15, 2021
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F348561-01 NY Primary

Addresses

Primary practice location

136 Parkway Dr
Cobleskill, NY 12043-5150

Mailing address

650 Creek Rd
Esperance, NY 12066-2808
Phone (518) 527-0809

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112002372 NY Practitioner - Nurse Practitioner 3173915667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F348561-01NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jan 24, 2022 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 24, 2022 Accepting new patients

Locations

136 Parkway Dr
Cobleskill, NY 12043
Phone (518) 234-2555

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Organizations & group practices 2

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.

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1457017485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 CREEK RD",
            "city": "ESPERANCE",
            "state": "NY",
            "postal_code": "120662808",
            "telephone_number": "518-527-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 PARKWAY DR",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120435150",
            "telephone_number": "518-234-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "BRENDAN",
        "middle_name": "PATRICK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F348561-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cobleskill, NY

Sources for this page

Verify at the official NPI Registry.