Individual provider Active NPI

Trevor Brown, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1912545682
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61312677 Issued in WA
Practice address
303 16TH Ave E Apt 205
Seattle, WA 98112-5157
Phone
(509) 863-7360
NPI assigned
Dec 12, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RN60990828 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61312677 WA Primary

Addresses

Primary practice location

303 16TH Ave E Apt 205
Seattle, WA 98112-5157

Mailing address

303 16TH Ave E Apt 205
Seattle, WA 98112-5157
Phone (509) 863-7360

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL NA
Other URL trevob@uw.edu University of Washington

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241220002657 NY Practitioner - Nurse Practitioner 1153858709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Empire State Psychiatric Medicine PLLCGroup PAC ID 0840721825, 10 clinicians

Practice addresses (Care Compare)

315 Madison Ave
RM 2000
New York, NY 10017-5416
Phone (646) 661-5225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61312677WAMDPsychiatric/Mental Health Nurse Practitioner
RN60990828WAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Empire State Psychiatric Medicine PLLC Psychiatric/Mental Health CurrentSince Nov 18, 2024 Accepting new patients

Locations

315 Madison Ave
Rm 2000
New York, NY 10017
Phone (646) 661-5225

Interoperability endpoints

  • Direct secure messaging: trevor.brown.1@31644.direct.athenahealth.com

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1912545682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 16TH AVE E APT 205",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125157",
            "telephone_number": "509-863-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 16TH AVE E APT 205",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125157",
            "telephone_number": "509-863-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TREVOR",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-12",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "RN60990828",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61312677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "I am a student",
            "address_1": "1959 NE Pacific St",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981950001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "trevob@uw.edu",
            "affiliation": "Y",
            "endpointDescription": "encrypted dual authentication email",
            "affiliationName": "University of Washington",
            "address_1": "1959 NE Pacific St",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981950001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.