Marc a. Brenner, D.P.M., PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N002371-1 Issued in NY

Legal business name

MARC A. BRENNER, D.P.M., PLLC

Practice address

2001 Marcus Avenue
Lake Success, NY 11042

Phone

(516) 355-2277

Fax

(516) 626-9243

NPI assigned

Dec 27, 2011

Organization subpart

No

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

Authorized official

Name

Sharese Welch

Title

Credentialing Specialist

Phone

(718) 573-1123

Specialties & licenses 1

Addresses

Other names 1

• Marc Alan brenner D.P.M., PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marc Alan Brenner, D.P.M.

  • Podiatrist
  • Glendale, NY
  • NPI 1093899734
  Medicare reassignment NPD
• Hank Ross, MD

  • Orthopaedic Surgery Physician
  • Mineola, NY
  • NPI 1104899517
  NPD (past)

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1912276643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 WHEATLEY RD",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681210",
            "telephone_number": "516-355-2277",
            "fax_number": "516-626-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVENUE",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-355-2277",
            "fax_number": "516-626-9243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7309 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "NY",
            "postal_code": "113857418",
            "country_code": "US",
            "telephone_number": "718-456-7270",
            "fax_number": "718-456-1874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARC A. BRENNER, D.P.M., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "SHARESE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "718-573-1123"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N002371-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marc Alan brenner D.P.M., PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Marc Alan brenner D.P.M., PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Livewell Occupational Therapy Services, PLLC
• Anna Loukissa, MD
• Nili Elana Major, MD
• Ummekalsoom Rahman Malik, MD
• Al'Tiana Manning, OD
• Sarah McElroy, LMSW
• Allison Bauman Mekhoubad, DO
• David Meryash, MD
• Sanford A Meyersfield, MD
• Perry J Milman, MD

• Podiatrist in Lake Success, NY
• Providers in Lake Success, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.