Individual provider Active NPI

Brandon Victor Witenzen, NP

  • Acute Care Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1750043469
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
432173 Issued in NY
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 275-7505
NPI assigned
Oct 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 432173 NY
Acute Care Nurse Practitioner 363LA2100X 432173 NY Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box Med
Rochester, NY 14642-0001
Phone (585) 275-4912

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bwitenzen83222@direct.urmc.rochester.edu Direct
Direct Messaging Address bwitenzen83222@direct.urmc.rochester.edu Direct

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
I20211130000303 NY Practitioner - Nurse Practitioner 0244620607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine GroupGroup PAC ID 3476454661, 166 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001
Phone (585) 275-7424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.12 of 100Reported as group
Quality
66.85
Promoting interoperability
100
Improvement activities
40
Cost
96.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
432173NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Group Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients
Internal Medicine Group CurrentSince Dec 13, 2021 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: bwitenzen83222@direct.urmc.rochester.edu

Organizations & group practices 4

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 2

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": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1750043469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX MED",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITENZEN",
        "first_name": "BRANDON",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-10",
        "last_updated": "2023-07-17",
        "certification_date": "2021-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "432173",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwitenzen83222@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwitenzen83222@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.