Individual provider Active NPI

Timothy S Brannan, MD

  • Neurology Physician
  • Jersey City, NJ
National Provider Identifier
1619946431
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MA65064 Issued in NJ
Practice address
377 Jersey Ave
Suite 220
Jersey City, NJ 07302-4393
Phone
(201) 309-2380
Fax
(201) 309-2381
NPI assigned
Mar 15, 2006
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MA65064 NJ Primary

Addresses

Primary practice location

377 Jersey Ave
Suite 220
Jersey City, NJ 07302-4393

Mailing address

377 Jersey Ave
Suite 220
Jersey City, NJ 07302-4393
Phone (201) 309-2380

Other identifiers 1

IdentifierTypeStateIssuer
7262906MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000221 NJ Practitioner - Neurology 0345409215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Pittsburgh School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

377 Jersey Ave
Suite 220
Jersey City, NJ 07302-4393

377 Jersey Ave
Suite 220
Jersey City, NJ 07302-4396
Phone (201) 309-2380

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA65064NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Family Health Network, Inc. CurrentSince Feb 20, 2018 Accepting new patients
Metropolitan Family Health Network, Inc CurrentSince Feb 20, 2018 Accepting new patients
Timothy Brannan, MD, LLC Neurology CurrentSince Jan 10, 2012 Accepting new patients
Jersey City Medical Center Past Accepting new patients
Jersey City Medical Center Past Accepting new patients
Barnabas Health Medical Group PC Past Accepting new patients

Locations

377 Jersey Ave
Ste 220
Jersey City, NJ 07302
Phone (201) 309-2380

935 Garfield Ave
Jersey City, NJ 07304
Phone (201) 478-5800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHEIBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1619946431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE",
            "address_2": "SUITE 220",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024393",
            "telephone_number": "201-309-2380",
            "fax_number": "201-309-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE",
            "address_2": "SUITE 220",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024393",
            "telephone_number": "201-309-2380",
            "fax_number": "201-309-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNAN",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA65064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7262906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.