Individual provider Active NPI

Brianna Rose Campbell, MSN, CPNP-AC

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1538989983
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383775-01 Issued in NY
Practice address
3959 Broadway
New York, NY 10032-1559
Phone
(212) 305-6628
NPI assigned
Oct 11, 2024
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F383775-01 NY Primary

Addresses

Primary practice location

3959 Broadway
New York, NY 10032-1559

Mailing address

112 E 83Rd St Apt 8B
New York, NY 10028-0880

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
I20241216003227 NY Practitioner - Nurse Practitioner 2163958042 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F383775-01NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Nov 6, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Nurse Practitioner CurrentSince Nov 6, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Nurse Practitioner Current Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

693 White Plains Rd
Eastchester, NY 10709
Phone (914) 787-3292

161 Fort Washington Ave
Fl 2
New York, NY 10032
Phone (212) 305-4308

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

51 W 51st St
Ste 370
New York, NY 10019
Phone (631) 254-5577

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
Ph 11
New York, NY 10032
Phone (212) 305-5976

155 White Plains Rd
Tarrytown, NY 10591
Phone (914) 332-7571

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: bgc9005@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1538989983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 83RD ST APT 8B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "BRIANNA",
        "middle_name": "ROSE",
        "credential": "MSN, CPNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383775-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.