Mary Ellen Brittis, M.D. – Ophthalmology Physician

Key facts

NPI: 1609921576
Entity type: Individual (NPI type 1)
Primary specialty: Ophthalmology Physician 207W00000X
License: 166425 (NY)
Practice address: 984 N Broadway
Suite 501
Yonkers, NY 10701-1318
Phone: (914) 965-2606
Fax: (914) 965-2880
NPI assigned: Jan 23, 2007
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

Hudson Retina, P.C. Retina Specialist (Ophthalmology) Physician · Yonkers, NY · NPI 1013163021

Medicare reassignment NPD Authorized official NY · OPHTHALMOLOGY

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NY
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20080813000536	NY	Practitioner - Ophthalmology	1759456569	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Hudson Retina, P.C.	Ophthalmology	Current since Jun 1, 1993	Accepting new patients

Locations

984 N Broadway
Ste 501
Yonkers, NY 10701
Phone (914) 636-1700

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Ophthalmology Physician	207W00000X	166425	NY	Yes

Addresses

Primary practice location

984 N Broadway
Suite 501
Yonkers, NY 10701-1318

Mailing address

984 N Broadway
Suite 501
Yonkers, NY 10701-1318
Phone (914) 965-2606

Other identifiers

Identifier	Type	State	Issuer
01453034	Medicaid	NY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 26, 2013.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1609921576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 N BROADWAY",
            "address_2": "SUITE 501",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011318",
            "telephone_number": "914-965-2606",
            "fax_number": "914-965-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 N BROADWAY",
            "address_2": "SUITE 501",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011318",
            "telephone_number": "914-965-2606",
            "fax_number": "914-965-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTIS",
        "first_name": "MARY ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "166425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01453034",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

All providers in Yonkers, NY · Ophthalmology Physician in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.