Brozellia Bryan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F330974 Issued in NY

Practice address

212 E 106TH St
New York, NY 10029-4007

Phone

(212) 360-2600

NPI assigned

Jul 28, 2005

Last updated

Nov 29, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: brozellia.bryan.1@32149.direct.athenahealth.com

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.

• Premier Healthcare, Inc.

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1760436190
  Medicare reassignment NPD
• Premier Healthcare, Inc.

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1831330182
  NPD
• Young Adult Institute, Inc.

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1144314576
  NPD
• Park Avenue Medical Associates, P.C.

  • Geriatric Medicine (Family Medicine) Physician
  • White Plains, NY
  • NPI 1730138645
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1497755698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E 106TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294007",
            "telephone_number": "212-360-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E 106TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294007",
            "telephone_number": "212-360-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "BROZELLIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F330974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Park Psychological Service, P.C.
• Bryan T Kelly MD PLLC
• Alicia May Bryan
• Ashley Bryan, PT
• Benjamin Robert Bryan, M.D.
• Caitlin Rose Bryan, DMD, MHS
• Gabrielle Bryan
• Isamar Bryan, CM
• Jaime Harrington Bryan, MD
• Joan Bryan, LCSW

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.