Individual provider Active NPI

John J Brosnan, MD

  • Obstetrics & Gynecology Physician
  • Albany, NY
National Provider Identifier
1467446849
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
152484 Issued in NY
Practice address
319 South Manning Blvd
Suite 201
Albany, NY 12208-1743
Phone
(518) 489-3296
Fax
(518) 489-4663
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 160632 NY
Obstetrics & Gynecology Physician 207V00000X 152484 NY Primary

Addresses

Primary practice location

319 South Manning Blvd
Suite 201
Albany, NY 12208-1743

Mailing address

PO Box 8915
Albany, NY 12208-0915
Phone (518) 489-3296

Other identifiers 1

IdentifierTypeStateIssuer
00998696MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
160632NYMDSpecialist
152484NYMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292544000000",
    "number": "1467446849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8915",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122080915",
            "telephone_number": "518-489-3296",
            "fax_number": "518-489-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 SOUTH MANNING BLVD",
            "address_2": "SUITE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081743",
            "telephone_number": "518-489-3296",
            "fax_number": "518-489-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSNAN",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "160632",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "152484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00998696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; 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.