Individual provider Active NPI

Brenna M Carrigan-McClinsey, AUD

  • Audiologist
  • Middletown, NY
National Provider Identifier
1902087208
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002177-1 Issued in NY
Practice address
95 Crystal Run Rd
Middletown, NY 10941-7001
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002177-1 NY Primary

Addresses

Primary practice location

95 Crystal Run Rd
Middletown, NY 10941-7001

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
03049341MedicaidNY

Other names 1

  • Brenna M Carrigan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brenna.carriganaud.p1@direct.crystalrun.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000070 NY Practitioner - Qualified Audiologist 3274613146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
State University of New York at Buffalo School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Crystal Run Rd
Middletown, NY 10941-4069
Phone (845) 692-6999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002177-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Run Healthcare Physicians LLP CurrentSince Jul 13, 2009 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Jul 13, 2009 Accepting new patients
Saint Francis Hospital / Medicine Past Accepting new patients

Locations

95 Crystal Run Rd
Middletown, NY 10941
Phone (845) 703-3800

155 Crystal Run Rd
Middletown, NY 10941

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

61 Emerald Pl
Rock Hill, NY 12775
Phone (845) 703-8999

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1902087208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417001",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIGAN-MCCLINSEY",
        "first_name": "BRENNA",
        "middle_name": "M",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002177-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03049341",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brenna.carriganaud.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "95 Crystal Run Rd",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109417001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRENNA",
            "last_name": "CARRIGAN",
            "middle_name": "M",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.