Individual provider Active NPI

Bryon Labrenz, M.D.

  • Family Medicine Physician
  • Lagrangeville, NY
National Provider Identifier
1548202021
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
171478 Issued in NY
Practice address
1351 Route 55
Suite 200
Lagrangeville, NY 12540-5108
Phone
(845) 475-9500
NPI assigned
Jun 11, 2006
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 171478 NY Primary

Addresses

Primary practice location

1351 Route 55
Suite 200
Lagrangeville, NY 12540-5108

Mailing address

1351 Route 55
Suite 200
Lagrangeville, NY 12540-5108
Phone (845) 475-9500

Other identifiers 1

IdentifierTypeStateIssuer
01159888MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110314000423 NY Practitioner - Family Practice 0749462679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
171478NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Dec 1, 2011 Accepting new patients
William Heffernan,M.D. Family Medicine PastSince Jun 1, 2015 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

1037 Main St
Peekskill, NY 10566
Phone (914) 734-8800

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, 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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1548202021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 ROUTE 55",
            "address_2": "SUITE 200",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405108",
            "telephone_number": "845-475-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 ROUTE 55",
            "address_2": "SUITE 200",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405108",
            "telephone_number": "845-475-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABRENZ",
        "first_name": "BRYON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "171478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01159888",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrangeville, NY

Sources for this page

Verify at the official NPI Registry.