Robert Blakely Bristow, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

200934 Issued in NY

Practice address

622 W 168 St PH 1 137
Columbia University Med Center
New York, NY 10032-3784

Phone

(212) 305-2995

Fax

(212) 305-6792

NPI assigned

Jul 12, 2006

Reactivated

Oct 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.bristow.1@2983.direct.athenahealth.com

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.

• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1801277629
  Medicare reassignment Care Compare group NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1730491945
  NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1740913763
  NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1790710184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168 ST PH 1 137",
            "address_2": "ASSOCIATES IN EMERGENCY SERVICES CUMC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323784",
            "telephone_number": "212-305-2995",
            "fax_number": "212-305-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168 ST PH 1 137",
            "address_2": "COLUMBIA UNIVERSITY MED CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323784",
            "telephone_number": "212-305-2995",
            "fax_number": "212-305-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOW",
        "first_name": "ROBERT",
        "middle_name": "BLAKELY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-10-02",
        "deactivation_date": "2006-07-19",
        "reactivation_date": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "200934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01754934",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley R Brissette, MD
• John A Brissette, R,PH.
• Matthew Bristol
• Nadine Bristol, NURSE PRACTITIONER
• Carine Bristout, NURSE PRACTITIONER
• Brianna Brite
• Adela Brito
• Arturo Brito, MD, MPH
• Corym Brito
• Francia N Brito, OT/L

• Emergency Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.