Active NPI
Michelle Brenseke
- Registered Dietitian
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 008659
- Practice address
- 150 Essex St
New York, NY 10002-2301 - Phone
- (212) 477-1120
- Fax
- (212) 477-8957
- NPI assigned
- Aug 1, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 008659 | NY | Primary |
Addresses
Primary practice location
150 Essex St
New York, NY 10002-2301
Mailing address
60 Madison Ave
5TH FL
New York, NY 10010-1600
Phone (212) 545-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00695941 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
132 E Main St
Bay Shore, NY 11706-8302
Phone (631) 647-2530
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008659 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronxcare Health System | Dietitian, Registered | Current | Accepting new patients |
| Bronxcare Health System | Current | Accepting new patients | |
| Bronxcare Health System | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| North Shore - Lij Medical PC | Current | Accepting new patients |
Locations
132 E Main St
Bay Shore, NY 11706
Phone (516) 697-2042
1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
9525 Queens Blvd
Fl 7
Rego Park, NY 11374
Phone (718) 575-9595
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Organizations & group practices 5
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.
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- Internal Medicine Physician
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- NPI 1245390855
-
- Methadone Clinic
- Bronx, NY
- NPI 1801428222
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476144000000",
"number": "1720531387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 MADISON AVE",
"address_2": "5TH FL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100101600",
"telephone_number": "212-545-2400",
"fax_number": "646-312-0481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 ESSEX ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100022301",
"telephone_number": "212-477-1120",
"fax_number": "212-477-8957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENSEKE",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-01",
"last_updated": "2016-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "008659",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00695941",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.