NPIMap

Individual provider Active NPI

Brenainn Mairtin Flanagan, M.D.,

  • Family Medicine Physician
  • Northport, NY
National Provider Identifier
1609164334
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
262618 Issued in NY
Practice address
12 Burr Ave
Northport, NY 11768-1927
Phone
(631) 708-4066
NPI assigned
Jul 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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 262618 NY Primary

Addresses

Primary practice location

12 Burr Ave
Northport, NY 11768-1927

Mailing address

12 Burr Ave
Northport, NY 11768-1927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120215000358 NY Practitioner - HospitalistPractitioner - Family Practice 9638337090 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Northport, NY

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

101 Saint Andrews LN
Suite 1
Glen Cove, NY 11542-2254
Phone (516) 674-1812

Hospital & facility affiliations

  • Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Plainview Hospital Hospital, Plainview, NY, CCN 330331

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Family Medicine CurrentSince Dec 21, 2016 Accepting new patients
Excel at Woodbury for Rehabilitation and Nursing LLC PastSince May 1, 2021 Accepting new patients
Vikas Desai MD PC PastSince Apr 8, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Huntington Hospital Association Past Accepting new patients
Glen Cove Hospital Past Accepting new patients

Locations

101 Saint Andrews Ln
Fl 1
Glen Cove, NY 11542
Phone (516) 674-1812

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: brenainnflanagan@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIEGBD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Excel at Woodbury for Rehabilitation and Nursing LLCWoodbury, NY, CCN 335231 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2021
Dec 11, 2025
Oasis Rehabilitation and Nursing, LLCCenter Moriches, NY, CCN 335402 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2022
Oct 29, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1609164334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BURR AVE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BURR AVE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681927",
            "telephone_number": "631-708-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "BRENAINN",
        "middle_name": "MAIRTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "262618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.