Individual provider Active NPI

Dennis A Brown, MD

  • Surgery Physician
  • Syracuse, NY
National Provider Identifier
1689625758
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
101066 Issued in NY
Practice address
739 Irving Avenue
Suite 450 Central New York Surgical Physicians PC
Syracuse, NY 13210
Phone
(315) 470-7364
Fax
(315) 470-5859
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 101066 NY Primary

Addresses

Primary practice location

739 Irving Avenue
Suite 450 Central New York Surgical Physicians PC
Syracuse, NY 13210

Mailing address

739 Irving Ave
Suite 450
Syracuse, NY 13210-1640
Phone (315) 470-7364

Other identifiers 1

IdentifierTypeStateIssuer
00540712MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101066NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1689625758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 IRVING AVE",
            "address_2": "SUITE 450",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101640",
            "telephone_number": "315-470-7364",
            "fax_number": "315-470-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 IRVING AVENUE",
            "address_2": "SUITE 450 CENTRAL NEW YORK SURGICAL PHYSICIANS PC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-470-7364",
            "fax_number": "315-470-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DENNIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "101066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00540712",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.