Individual provider Active NPI

Charles Brown, PA-C

  • Surgical Physician Assistant
  • Purchase, NY
National Provider Identifier
1649647678
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
210 Westchester Avenue
Purchase, NY 10577
Phone
(914) 682-6540
NPI assigned
Aug 25, 2015
Last updated
Aug 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NY Primary

Addresses

Primary practice location

210 Westchester Avenue
Purchase, NY 10577

Mailing address

315 92ND St
Apartment 1F
Brooklyn, NY 11209-6377
Phone (757) 343-5649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180328002540 CT Practitioner - Physician Assistant 5698075828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

1 Hospital PLZ
Stamford, CT 06902-3602
Phone (203) 276-1000

29 Hospital PLZ
Stamford, CT 06902-3602

32 Strawberry Hill CT
Stamford, CT 06902-2594

4 Hospital PLZ
Suite 102
Stamford, CT 06902-3602
Phone (203) 276-2330

5 High Ridge Park
Suite 103
Stamford, CT 06905-1326
Phone (203) 276-4644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
019166NYMDClinical Child & Adolescent Psychologist

Interoperability endpoints

  • Direct secure messaging: cbrown24396@stamfordhealth.direct-ci.com

Organizations & group practices 1

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 1

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1649647678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 92ND ST",
            "address_2": "APARTMENT 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112096377",
            "telephone_number": "757-343-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVENUE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "10577",
            "telephone_number": "914-682-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

Verify at the official NPI Registry.