Individual provider Active NPI

Timothy Brandriff, PA

  • Physician Assistant
  • Greenwich, CT
National Provider Identifier
1740320092
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017907 Issued in NY
Practice address
81 Holly Hill LN FL 3
Greenwich, CT 06830-6071
Phone
(203) 869-5515
Fax
(203) 869-5765
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA000913 PA
Medical Physician Assistant 363AM0700X 003346 CT
Physician Assistant 363A00000X 017907 NY Primary

Addresses

Primary practice location

81 Holly Hill LN FL 3
Greenwich, CT 06830-6071

Mailing address

81 Holly Hill LN FL 3
Greenwich, CT 06830-6071
Phone (203) 869-5515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150211001564 NY Practitioner - Physician Assistant 0345215984 Reassigns benefits to 3 organizations
I20160920001920 CT Practitioner - Physician Assistant 0345215984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ny Mobile Medical PCGroup PAC ID 1850678053, 2 clinicians
Mobile Care Solutions PCGroup PAC ID 2365723970, 2 clinicians
Gandelman Cardiology, PCGroup PAC ID 1355437484, 3 clinicians

Practice addresses (Care Compare)

2175 Quarry Rd
Bronx, NY 10457-1663
Phone (203) 869-5515

67 Holly Hill LN
Suite 102
Greenwich, CT 06830-2942

81 Holly Hill LN
FL 3
Greenwich, CT 06830-2941

81 Holly Hill LN
FL 3
Greenwich, CT 06830-6071
Phone (203) 869-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003346CTMDClinical Psychologist
OA000913PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Nov 9, 2014 Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • Direct secure messaging: timothy.brandriff@direct.einstein.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1740320092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HOLLY HILL LN FL 3",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306071",
            "telephone_number": "203-869-5515",
            "fax_number": "203-869-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HOLLY HILL LN FL 3",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306071",
            "telephone_number": "203-869-5515",
            "fax_number": "203-869-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDRIFF",
        "first_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA000913",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003346",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.