NPIMap

Individual provider Active NPI

Marina Bravin, M.D.

  • Internal Medicine Physician
  • Cooperstown, NY
National Provider Identifier
1679538409
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
229196 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-6542
Fax
(607) 547-4648
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 229196 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

PO Box 725
Cooperstown, NY 13326-0725
Phone (607) 547-6542

Other identifiers 1

IdentifierTypeStateIssuer
02655512MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050708000590 NY Practitioner - Dermatology 1759317068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of New York at Buffalo School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett Hospital 780 clinicians

Practice addresses (Care Compare)

1 Associate Dr
Oneonta, NY 13820-2266
Phone (607) 433-6300

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

321 E Albany St
Herkimer, NY 13350-2016
Phone (315) 867-2700

Greystone Commercial Park
4580 State Route 28
Milford, NY 13807-1147
Phone (607) 547-7646

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
  • Cobleskill Regional Hospital Hospital, Cobleskill, NY, CCN 331320
  • Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision23
Removal of skin lesions1960
Removal or shaving of skin growth23
Skin biopsy354

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229196NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Aug 1, 2005 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 1, 2005 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

4580 State Highway 28
Milford, NY 13807
Phone (607) 547-6542

Interoperability endpoints

  • Direct secure messaging: mbravin5974@bassett.direct-ci.net

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1679538409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-6542",
            "fax_number": "607-547-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-6542",
            "fax_number": "607-547-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVIN",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "229196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02655512",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.