Individual provider Active NPI

Gina A Brothers, ANP

  • Urology Physician
  • Liverpool, NY
National Provider Identifier
1811961725
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
F3006101 Issued in NY
Practice address
5100 W Taft Rd
Suite 4-D
Liverpool, NY 13088-3807
Phone
(315) 458-6669
Fax
(315) 458-0819
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X F3006101 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 4-D
Liverpool, NY 13088-3807

Mailing address

1226 E Water St
Syracuse, NY 13210-1155
Phone (315) 478-4185

Other identifiers 1

IdentifierTypeStateIssuer
02287027MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3006101NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Urology Associates Urology Past Accepting new patients

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1811961725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 4-D",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-458-6669",
            "fax_number": "315-458-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERS",
        "first_name": "GINA",
        "middle_name": "A",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "F3006101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02287027",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.