Individual provider Active NPI

Brandon Nam, PT, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1700514189
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049057 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2508
Phone
(718) 630-7000
NPI assigned
Aug 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 049057 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2508

Mailing address

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126001431 NY Practitioner - Physical Therapist in Private Practice 3870964075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchor Health Homecare Services IncGroup PAC ID 2163802570, 96 clinicians
Physical Therapy Services of Flatiron PCGroup PAC ID 1759784085, 112 clinicians

Practice addresses (Care Compare)

Brooklyn, NY 11206
Phone (718) 701-7300

138 5TH Ave
FL 2
New York, NY 10011-4367
Phone (212) 287-4257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049057NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Health Homecare Services Inc Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Mar 30, 2025 Accepting new patients

Locations

958 Nostrand Ave
Brooklyn, NY 11225
Phone (347) 423-9031

46 Cook St
Brooklyn, NY 11206
Phone (718) 701-7300

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

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.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1700514189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "BRANDON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.