Active NPI
Dennis A Brown, MD
- Surgery Physician
- Syracuse, NY
National Provider Identifier
1689625758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 101066
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00540712 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 101066 | NY | MD | Clinical 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.