A Alexis Brosen, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

137356 Issued in NY

Practice address

2415 Main St
Bridgehampton, NY 11932-4054

Phone

(917) 860-8334

Fax

(866) 670-3096

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 19, 2015 through Jun 19, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 21, 2023.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1780801985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1562",
            "city": "BRIDGEHAMPTON",
            "state": "NY",
            "postal_code": "119321562",
            "telephone_number": "917-860-8334",
            "fax_number": "866-670-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MAIN ST",
            "city": "BRIDGEHAMPTON",
            "state": "NY",
            "postal_code": "119324054",
            "telephone_number": "917-860-8334",
            "fax_number": "866-670-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSEN",
        "first_name": "A",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "137356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Atlas, PHARM.D.
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• Dori Fortunato, DAOM, LIC. AC. LMT

• All providers in Bridgehampton, NY
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.