NPIMap

Individual provider Active NPI

Teresa L Brevetti, MD

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1528056074
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
215288-1 Issued in NY
Practice address
2601 Ocean Pkwy
Coney Island Hospital Dept of Surgery
Brooklyn, NY 11235-7745
Phone
(718) 616-3440
Fax
(718) 616-4436
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 215288-1 NY Primary

Addresses

Primary practice location

2601 Ocean Pkwy
Coney Island Hospital Dept of Surgery
Brooklyn, NY 11235-7745

Mailing address

PO Box 777
Tenafly, NJ 07670-0777
Phone (718) 616-3440

Other identifiers 7

IdentifierTypeStateIssuer
7955259OtherNYAETNA PPO ID #
20-0278746OtherNYTAX ID #
506A91OtherNYEMPIRE BCBS OF NY ID #
0498091OtherNYGHI PPO ID #
3622352OtherNYAETNA HMO ID #
4C8738OtherNYHEALTHNET ID #
P3608471OtherNYOXFORD ID #

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
215288-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
University Group Medical Associates, P.C Past Accepting new patients
Ayman Z. Matta, M.D., P.C. Past Accepting new patients
University Physicians of Brooklyn, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tbrevetti144730@nychhc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1528056074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 777",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076700777",
            "telephone_number": "718-616-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "address_2": "CONEY ISLAND HOSPITAL DEPT OF SURGERY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "718-616-3440",
            "fax_number": "718-616-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREVETTI",
        "first_name": "TERESA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "215288-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO ID #",
            "identifier": "7955259",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "20-0278746",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS OF NY ID #",
            "identifier": "506A91",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO ID #",
            "identifier": "0498091",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO ID #",
            "identifier": "3622352",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID #",
            "identifier": "4C8738",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID #",
            "identifier": "P3608471",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.