Individual provider Active NPI

Tara Ann Brinkmann, M.S.ED.

  • Specialist
  • Massapequa, NY
National Provider Identifier
1770838286
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
821689 Issued in NY
Practice address
96 N Cedar St
Massapequa, NY 11758-2629
Phone
(516) 798-0938
Fax
(516) 798-0938
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 821689 NY Primary

Addresses

Primary practice location

96 N Cedar St
Massapequa, NY 11758-2629

Mailing address

96 N Cedar St
Massapequa, NY 11758-2629
Phone (516) 798-0938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
821689NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1770838286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 N CEDAR ST",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582629",
            "telephone_number": "516-798-0938",
            "fax_number": "516-798-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 N CEDAR ST",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582629",
            "telephone_number": "516-798-0938",
            "fax_number": "516-798-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKMANN",
        "first_name": "TARA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "821689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.