Individual provider Active NPI

Brandon David Johnson, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1649560830
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
269380 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6574
Phone
(212) 659-8734
NPI assigned
Apr 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 269380 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6574

Mailing address

1090 Amsterdam Ave Ste 16F
New York, NY 10025-1737
Phone (972) 351-7391

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160628001054 NY Practitioner - Psychiatry 6608167374 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Psychiatry CurrentSince Jun 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Psychiatry CurrentSince Jun 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2018 Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1090 Amsterdam Ave
Ste 16F
New York, NY 10025

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

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": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1649560830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE STE 16F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "972-351-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-659-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRANDON",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-09",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "269380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.