Individual provider Active NPI

Brandon Concepcion, P.A.

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1568916120
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
020006 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2508
Phone
(347) 261-3075
NPI assigned
Aug 11, 2016
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 020006 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2508

Mailing address

72 Merivale LN
Staten Island, NY 10304-3859

Other practice location 1

72 Merivale Ln
Staten Island, NY 10304-3859
Phone (347) 261-3075

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bconcepcion142333@nyumc.direct-ci.com

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
I20180831000853 NY Practitioner - Physician Assistant 0749530335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 23, 2018 Accepting new patients
New York University CurrentSince Jul 23, 2018 Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: bconcepcion142333@nyumc.direct-ci.com

Organizations & group practices 2

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": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1568916120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MERIVALE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "347-261-3075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 Merivale Ln",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103043859",
            "country_code": "US",
            "telephone_number": "347-261-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "BRANDON",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "020006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bconcepcion142333@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.