Brynn Nicole McKeon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

020076 Issued in NY

Practice address

38 Concord Rd
Monticello, NY 12701-3210

Phone

(845) 333-6500

Fax

(845) 333-6501

NPI assigned

Sep 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brynn Nicole Bertholf Former name

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garnet Health Doctors PCGroup PAC ID 8628293545, 165 clinicians

Garnet Health Urgent Care PCGroup PAC ID 5395009765, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sullivan County Public Health Services Chha Home health agency, Liberty, NY, CCN 337165
• Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386
• Garnet Health Medical Center Catskills Hospital, Callicoon, NY, CCN 331303
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

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.

• Garnet Health Doctors PC

  • General Practice Physician
  • Middletown, NY
  • NPI 1093138851
  Medicare reassignment Care Compare group
• Garnet Health Urgent Care PC

  • Urgent Care Clinic/Center
  • Middletown, NY
  • NPI 1316446651
  Medicare reassignment Care Compare group

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

• Catskill Regional Medical Center

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563

  Hospital

  Care Compare affiliation
• County of Sullivan

  • Home Health Agency
  • Liberty, NY
  • NPI 1710915400
  Care Compare affiliation
• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• Garnet Health Medical Center Catskills

  • Critical Access Hospital
  • Callicoon, NY
  • NPI 1649251554
  Care Compare affiliation
• Garnet Health Medical Center Catskills

  • Rural Acute Care Hospital
  • Harris, NY
  • NPI 1710977012
  Care Compare affiliation
• Sullivan County Public Health Services

  • Home Health Agency
  • Liberty, NY
  • NPI 1770639445
  Care Compare affiliation

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1669929899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 CONCORD RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127013210",
            "telephone_number": "845-333-6500",
            "fax_number": "845-333-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 CONCORD RD",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127013210",
            "telephone_number": "845-333-6500",
            "fax_number": "845-333-6501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1522 State Route 17B",
            "address_purpose": "LOCATION",
            "city": "White Lake",
            "state": "NY",
            "postal_code": "127865428",
            "country_code": "US",
            "telephone_number": "845-333-6600",
            "fax_number": "845-583-8084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "BRYNN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "020076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05528065",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmckeon50333@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "address_1": "1522 State Route 17B",
            "city": "White Lake",
            "state": "NY",
            "country_code": "US",
            "postal_code": "127865428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRYNN",
            "last_name": "BERTHOLF",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy McDonald, M.S. CCC
• Timothy L McDonald, SOCIAL WORKER
• Cornelius McFarland
• Chris Joseph McGinnis, DPT
• Kelly McGrath-Taylor, CASAC
• Kelli McMahon
• Rosetta McNeal, RN
• Kerrilynn Mears
• Med Car Corp
• Medex

• Medical Physician Assistant in Monticello, NY
• Providers in Monticello, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.