Organization Active NPI

Elise M Brett MD PC

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
National Provider Identifier
1609313667
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
10128 Issued in NY
Legal business name
ELISE M BRETT MD PC
Practice address
1192 Park Ave
New York, NY 10128-1314
Phone
(212) 831-1371
NPI assigned
Jan 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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

Authorized official

Name
Alexa Besgen
Title
Credentialing Manager
Phone
(914) 437-5850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X 10128 NY Primary

Addresses

Primary practice location

1192 Park Ave
New York, NY 10128-1314

Mailing address

1192 Park Ave
New York, NY 10128-1314
Phone (212) 831-1371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170301002040 NY Part B Supplier - Clinic/Group Practice 6002190535 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10036569

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1609313667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1192 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281314",
            "telephone_number": "212-831-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281314",
            "telephone_number": "212-831-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISE M BRETT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "BESGEN",
        "authorized_official_first_name": "ALEXA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "914-437-5850"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "10128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.