NPIMap

Individual provider Active NPI

Timothy Koehler Brennan, MD

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • New York, NY
National Provider Identifier
1689820474
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
260958 Issued in NY
Practice address
1000 10TH Ave FL 8
New York, NY 10019
Phone
(212) 523-8943
Fax
(212) 523-8057
NPI assigned
Aug 12, 2008
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 260958 NY Primary

Addresses

Primary practice location

1000 10TH Ave FL 8
New York, NY 10019

Mailing address

1400 Irving St NW
#312
Washington, DC 20010-2850

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
I20130226000479 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6800041716 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Tulane University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1425 Madison Ave
New York, NY 10029-6514
Phone (212) 824-8150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Addiction Medicine CurrentSince Mar 1, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Dec 13, 2012 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Weill Medical College of Cornell CurrentSince Nov 12, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Dec 13, 2012 Accepting new patients
Weill Medical College of Cornell CurrentSince Nov 12, 2012 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2018 Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1000 10th Ave
Fl 8
New York, NY 10019
Phone (212) 523-6481

1090 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2211

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Networks

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

Interoperability endpoints

  • Direct secure messaging: tkb9001@direct.nyp.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1689820474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 IRVING ST NW",
            "address_2": "#312",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-523-8943",
            "fax_number": "212-523-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "TIMOTHY",
        "middle_name": "KOEHLER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "260958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.