Mark Leonard Brandon, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

238123 Issued in NY

Practice address

11 Ralph PL
Suite 102
Staten Island, NY 10304-4401

Phone

(718) 447-6545

Fax

(718) 447-5297

NPI assigned

Oct 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Columbia University College of Physicians and Surgeons, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mark.brandon.1@19656.direct.athenahealth.com

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.

• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975
  Medicare reassignment Care Compare group NPD
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD
• Richmond Medical Center

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1740389154
  NPD (past)
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Richmond Medical Center

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1740389154
  Care Compare affiliation

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1649423146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 102",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-447-6545",
            "fax_number": "718-447-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 102",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044401",
            "telephone_number": "718-447-6545",
            "fax_number": "718-447-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "MARK",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "238123",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA08490300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Brancato
• Barbara Brandi, LMSW
• Margarita Brandis, MSED
• Peter Brandis
• Polina Brandis, M.S. J.D.
• Joseph Gerald Brandt Sr., PTA
• Mela Brandt, M.S., CCC/SLP
• David Robert Brandwein, PSYD.
• Pamela Brandwein
• Jo-Ellen Brannigan

• Sports Medicine (Orthopaedic Surgery) Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.