Individual provider Active NPI

Brianna Sherwood, PA-C

  • Physician Assistant
  • Commack, NY
National Provider Identifier
1720534134
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020063-1 Issued in NY
Practice address
353 Veterans Memorial Hwy
#101
Commack, NY 11725-4200
Phone
(631) 543-4888
NPI assigned
Aug 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020063-1 NY Primary

Addresses

Primary practice location

353 Veterans Memorial Hwy
#101
Commack, NY 11725-4200

Mailing address

353 Veterans Memorial Hwy
#101
Commack, NY 11725-4200
Phone (631) 543-4888

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180228002474 NY Practitioner - Physician Assistant 2961763214 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020063-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Dermatology & Mohs Surgery Group, PLLC CurrentSince Jan 3, 2018 Accepting new patients

Locations

353 Veterans Memorial Hwy
Fl 1
Commack, NY 11725

353 Veterans Memorial Hwy
Ste 101
Commack, NY 11725
Phone (631) 543-4888

225 W Montauk Hwy
Ste 3
Hampton Bays, NY 11946
Phone (212) 518-4562

820 2nd Ave
Rm 3A
New York, NY 10017
Phone (212) 661-3376

516 Old Country Rd
Plainview, NY 11803
Phone (516) 433-2424

Interoperability endpoints

  • Direct secure messaging: brianna.scotti.1@7628.direct.athenahealth.com

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": "1472256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1720534134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "address_2": "#101",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 VETERANS MEMORIAL HWY",
            "address_2": "#101",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254200",
            "telephone_number": "631-543-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "BRIANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-27",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020063-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.