Active NPI
Brian Traub, MD
- General Practice Physician
- Bronx, NY
National Provider Identifier
1790280428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 312942
- Practice address
- 1400 Pelham Pkwy S
Bronx, NY 10461-1197 - Phone
- (718) 696-2583
- Fax
- (718) 881-5074
- NPI assigned
- Mar 26, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 312942 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 312942 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Bronx, NY 10461-1197
Mailing address
57 Duer LN
Staten Island, NY 10301-3014
Other practice location 1
111 E 210th St
Bronx, NY 10467-2401
Phone (718) 696-2583
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CTD Network LLC | General Practice | Current | Accepting new patients |
Locations
442 5th Ave
#2115
New York, NY 10018
Organizations & group practices 1
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": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1790280428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 DUER LN",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611197",
"telephone_number": "718-696-2583",
"fax_number": "718-881-5074"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-696-2583",
"fax_number": "718-696-2583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRAUB",
"first_name": "BRIAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-26",
"last_updated": "2022-05-12",
"certification_date": "2022-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "312942",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "312942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.