Individual provider Active NPI

Kerianne B Brady, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1902982275
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
239898 Issued in NY
Practice address
MMC - Dept of Pediatrics
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 741-2150
NPI assigned
Oct 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 239898 NY Primary

Addresses

Primary practice location

MMC - Dept of Pediatrics
111 East 210TH Street
Bronx, NY 10467

Mailing address

2047 33Rd St
Astoria, NY 11105-2025
Phone (718) 267-2148

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140825000704 NY Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 0749282036 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Emergency Medical Associates PLLC CurrentSince Aug 1, 2014 Accepting new patients
Montefiore Medical Center Pediatrics Past Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

Interoperability endpoints

  • Direct secure messaging: kbb9002@direct.nyp.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902982275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2047 33RD ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052025",
            "telephone_number": "718-267-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT OF PEDIATRICS",
            "address_2": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-741-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "KERIANNE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "239898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.