Madeleine M O'Brien
Individual provider Active NPI Psychiatry Physician · Marcy, NY
NPI 1669674255 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669674255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 180559 (NY)
- Practice address
- 300 Wright Avenue
Marcy, NY 13404 - Phone
- (315) 736-8271
- NPI assigned
- Jun 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090526000255 | NY | Practitioner - Psychiatry | 4284783176 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Medical Practice Plan PC | Current |
Accepting new patients | |
| Downtown Bronx Medical Associates PC | Current |
Accepting new patients |
Locations
234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874
1901 1st Ave
New York, NY 10029
Phone (212) 230-6262
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- mobrien838424@nychhc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 180559 | NY | Yes |
Addresses
Primary practice location
300 Wright Avenue
Marcy, NY 13404
Mailing address
7 Rocky RDG
Cortlandt Manor, NY 10567-6530
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180559 | Medicaid | NY |
Other providers in Marcy, NY
- Lucie W Murray
- Richelle Murray
- Jennifer Jean Nellis
- Sarah W Nelson
- Nys Office of Mental Health
- Domenica Mary O'Donnell
- Shauna Alise Ogden
- Amy Palmer
- James Anthony Palombo
- Shelly Pasquarelli
All providers in Marcy, NY · Psychiatry Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.