NPIMap

Individual provider Active NPI

Matthew Sean Brennan, DO

  • Urology Physician
  • Orchard Park, NY
National Provider Identifier
1831538057
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
307569 Issued in NY
Practice address
500 Sterling Dr
Orchard Park, NY 14127-1573
Phone
(716) 677-2273
Fax
(716) 677-2256
NPI assigned
Jun 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X OS15234 FL
Urology Physician 208800000X 307569 NY Primary

Addresses

Primary practice location

500 Sterling Dr
Orchard Park, NY 14127-1573

Mailing address

2263 SW 37TH Ave Apt 441
Miami, FL 33145-3262
Phone (716) 208-6781

Other practice location 1

3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone (716) 677-2273

Other identifiers 1

IdentifierTypeStateIssuer
06239569MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201224000639 NY Practitioner - Urology 0547503997 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Physician PCGroup PAC ID 9133434269, 65 clinicians

Practice addresses (Care Compare)

500 Sterling Dr
Orchard Park, NY 14127-1573
Phone (716) 677-2273

Hospital & facility affiliations

  • Kaleida Health Hospital, Buffalo, NY, CCN 330005
  • Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
  • Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078
  • Brooks-TLC Hospital System, Inc Hospital, Dunkirk, NY, CCN 330229
  • Bertrand Chaffee Hospital Hospital, Springville, NY, CCN 330111

Merit-based Incentive Payment System (MIPS)

Final score
75.58 of 100Reported as group
Quality
39.81
Promoting interoperability
88
Improvement activities
40
Cost
83.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection15
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
307569NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physician, PC Urology CurrentSince Jan 1, 2021 Accepting new patients
Miami Mens Health Urology CurrentSince Jul 28, 2019 Accepting new patients
Harlem Road Ambulatory Surgery Center LLC CurrentSince Oct 10, 2023 Accepting new patients
Great Lakes Physician, PC Urology CurrentSince Jan 1, 2021 Accepting new patients

Locations

135 San Lorenzo Ave
Ste 540
Coral Gables, FL 33146
Phone (305) 444-2290

726 Exchange St
Ste 200
Buffalo, NY 14210

3085 Harlem Rd
Ste 200
Cheektowaga, NY 14225
Phone (716) 844-5000

3085 Harlem Rd
Ste 300
Cheektowaga, NY 14225
Phone (716) 422-5422

3085 Harlem Rd
Ste 350
Cheektowaga, NY 14225
Phone (716) 844-5000

3040 Amsdell Rd
Hamburg, NY 14075
Phone (716) 646-6700

500 Sterling Dr
Orchard Park, NY 14127
Phone (716) 677-2273

Interoperability endpoints

  • Direct secure messaging: mbrennan@qualitycare.medentdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1831538057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2263 SW 37TH AVE APT 441",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453262",
            "telephone_number": "716-208-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STERLING DR",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271573",
            "telephone_number": "716-677-2273",
            "fax_number": "716-677-2256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3040 Amsdell Rd",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "NY",
            "postal_code": "140755835",
            "country_code": "US",
            "telephone_number": "716-677-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "MATTHEW",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "OS15234",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "307569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06239569",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.