Individual provider Active NPI

Brian Locsin, DNP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1639615636
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
308155 Issued in NY
Practice address
600 3Rd Ave FL 2
New York, NY 10016-1919
Phone
(617) 505-1520
Fax
(617) 928-8401
NPI assigned
Jan 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308155 NY Primary
Registered Nurse 163W00000X 95283940 CA
Registered Nurse 163W00000X 041523720 IL
Adult Health Nurse Practitioner 363LA2200X 209025964 IL
Registered Nurse 163W00000X 1057202 TX
Adult Health Nurse Practitioner 363LA2200X 95022446 CA
Registered Nurse 163W00000X 634664 NY
Adult Health Nurse Practitioner 363LA2200X 1057202 TX

Addresses

Primary practice location

600 3Rd Ave FL 2
New York, NY 10016-1919

Mailing address

109 State St Ste 5
Boston, MA 02109-2906
Phone (617) 505-1520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006000127 NY Practitioner - Nurse Practitioner 9436424173 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95283940CAMDRegistered Nurse
041523720ILMDRegistered Nurse
634664NYMDRegistered Nurse
95022446CAMDAdult Health Nurse Practitioner
209025964ILMDAdult Health Nurse Practitioner
308155NYMDAdult Health Nurse Practitioner
1057202TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 22, 2017 Accepting new patients
New York University CurrentSince Aug 22, 2017 Accepting new patients
Form Health Associates Ma, P.C. Past Accepting new patients
Eden Health Medical PC PastSince Nov 24, 2024 Accepting new patients
Eden Health Medical of Il LTD PastSince Nov 24, 2024 Accepting new patients

Locations

3503 31st Ave
Astoria, NY 11106
Phone (212) 263-5969

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: brian.locsin@168064768409604.direct.elationemr.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1639615636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STATE ST STE 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092906",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 3RD AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161919",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCSIN",
        "first_name": "BRIAN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-13",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308155",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95283940",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041523720",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209025964",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1057202",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95022446",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "634664",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1057202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.