Individual provider Active NPI

Moshe Wolbrom, NP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1689498859
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355299 Issued in NY
Practice address
1122 Chestnut Ave
Brooklyn, NY 11230-5844
Phone
(718) 942-3888
NPI assigned
Nov 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355299 NY Primary

Addresses

Primary practice location

1122 Chestnut Ave
Brooklyn, NY 11230-5844

Mailing address

1122 Chestnut Ave
Brooklyn, NY 11230-5844

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
I20250326001382 NY Practitioner - Nurse Practitioner 5193248664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1220 Ave P
Brooklyn, NY 11229-1009
Phone (718) 376-1004

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

1624 E 14TH St
Brooklyn, NY 11229-1104
Phone (708) 376-2220

22414 Merrick Blvd
Laurelton, NY 11413-2023
Phone (718) 949-6433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
355299NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 7, 2025 Accepting new patients
New York University CurrentSince Apr 7, 2025 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

1220 Avenue P
Brooklyn, NY 11229
Phone (718) 375-7546

1630 E 14th St
Brooklyn, NY 11229
Phone (516) 612-3722

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: mwolbrom269671@nyumc.direct-ci.com

Organizations & group practices 2

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 7

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": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1689498859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 CHESTNUT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 CHESTNUT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305844",
            "telephone_number": "718-942-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLBROM",
        "first_name": "MOSHE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.