Individual provider Active NPI

Brian R Kline, MD

  • Family Medicine Physician
  • Fayetteville, NY
National Provider Identifier
1689965303
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
276281 Issued in NY
Practice address
4104 Medical Center Drive
Suite 104
Fayetteville, NY 13066
Phone
(315) 663-0059
Fax
(315) 663-0123
NPI assigned
Apr 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 276281 NY
Family Medicine Physician 207Q00000X 276281 NY Primary

Addresses

Primary practice location

4104 Medical Center Drive
Suite 104
Fayetteville, NY 13066

Mailing address

5112 West Taft Road
Suite L
Liverpool, NY 13088
Phone (315) 744-1864

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141031000917 NY Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 4789805912 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

2949 Nys Rte
Suite 370
Cato, NY 13033
Phone (315) 626-2117

5100 W Taft Rd
Liverpool, NY 13088-3807
Phone (315) 452-2828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276281NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Hospital Health Center Family Medicine CurrentSince Aug 15, 2014 Accepting new patients
North Medical PC Family Medicine Current Accepting new patients
Familycare Medical Group, PC Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Aug 15, 2014 Accepting new patients
St. Joseph'S Pathology, PC Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Aug 15, 2014 Accepting new patients

Locations

2949 State Route 370
Cato, NY 13033
Phone (315) 626-2117

4104 Medical Center Dr
Ste 104
Fayetteville, NY 13066
Phone (315) 663-0059

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

5112 W Taft Rd
Ste L
Liverpool, NY 13088

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

Interoperability endpoints

  • Direct secure messaging: bkline2386876@direct.trinity-health.org
  • Direct secure messaging: bkline@fcmg.medentdirect.com

Organizations & group practices 6

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1689965303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WEST TAFT ROAD",
            "address_2": "SUITE L",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-744-1864",
            "fax_number": "315-452-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 MEDICAL CENTER DRIVE",
            "address_2": "SUITE 104",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-663-0059",
            "fax_number": "315-663-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "276281",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "276281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.