Individual provider Active NPI

Brendon Cohen

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1659082477
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone
(718) 250-8000
NPI assigned
Dec 13, 2022
Last updated
Dec 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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 NU Primary

Addresses

Primary practice location

121 Dekalb Ave
Brooklyn, NY 11201-5425

Mailing address

3 Sleepy Hollow CT
Lake Grove, NY 11755-2615
Phone (631) 514-9496

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
I20240723002060 NY Practitioner - Physician Assistant 4486190774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Suffolk HospitalGroup PAC ID 4981508082, 94 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hospital CurrentSince Jul 15, 2024 Accepting new patients

Locations

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

Interoperability endpoints

  • Direct secure messaging: bcohen69539@northwell.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": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1659082477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SLEEPY HOLLOW CT",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552615",
            "telephone_number": "631-514-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015425",
            "telephone_number": "718-250-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "BRENDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.