NPIMap

Individual provider Active NPI

Collin E M Brathwaite, MD

  • Specialist
  • Mineola, NY
National Provider Identifier
1619075512
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
211561 Issued in NY
Practice address
120 Mineola Blvd
Suite 320
Mineola, NY 11501-4073
Phone
(516) 663-3300
Fax
(516) 663-2136
NPI assigned
Sep 21, 2006
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 211561 NY Primary

Addresses

Primary practice location

120 Mineola Blvd
Suite 320
Mineola, NY 11501-4073

Mailing address

120 Mineola Blvd
Suite 320
Mineola, NY 11501-4073
Phone (516) 663-3300

Other identifiers 9

IdentifierTypeStateIssuer
23R982OtherNYEMPIRE BC BS
0199636OtherNYGHI
5856167OtherNYAETNA
P3072342OtherNYOXFORD FREEDOM PLAN
N90256OtherNYHEALTHNET
158053OtherNYVYTRA
5808725008OtherNYCIGNA
AA72078OtherNYMDNY
01875290MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbrathwaite230605@nyumc.direct-ci.com

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
I20040412000116 NY Practitioner - General Surgery 3072507391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Howard University College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

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

157 E Woodside Ave
Patchogue, NY 11772-1423
Phone (631) 475-1900

221 Jericho Turnpike
Syosset, NY 11791-4515
Phone (516) 496-6500

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 29, 2025 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
North Shore - Lij Medical PC CurrentSince Dec 29, 2025 Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Past Accepting new patients
Collin Em Brathwaite MD PLLC PastSince Nov 1, 2004 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

300 Community Dr
Manhasset, NY 11030

120 Mineola Blvd
Ste 320
Mineola, NY 11501
Phone (516) 663-3300

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

48 Route 25A
Ste LL7
Smithtown, NY 11787
Phone (631) 784-7400

221 Jericho Tpke
Syosset, NY 11791
Phone (516) 496-6400

Networks

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

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1619075512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 320",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-3300",
            "fax_number": "516-663-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 320",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-3300",
            "fax_number": "516-663-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "COLLIN",
        "middle_name": "E M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "211561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC BS",
            "identifier": "23R982",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0199636",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5856167",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD FREEDOM PLAN",
            "identifier": "P3072342",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "N90256",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "158053",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5808725008",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AA72078",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01875290",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbrathwaite230605@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "120 Mineola Blvd",
            "address_2": "Suite 320",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.