Individual provider Active NPI

Brett Anderson, M.D.

  • Pediatric Cardiology Physician
  • New York, NY
National Provider Identifier
1922298165
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
MD261249-1 Issued in NY
Practice address
3959 Broadway # CH-2N
New York, NY 10032-1559
Phone
(212) 305-8509
Fax
(212) 305-4429
NPI assigned
Jul 25, 2007
Last updated
Jan 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT191203 PA
Pediatric Cardiology Physician 2080P0202X MD261249-1 NY Primary

Addresses

Primary practice location

3959 Broadway # CH-2N
New York, NY 10032-1559

Mailing address

3959 Broadway # CH-2N
New York, NY 10032-1559
Phone (212) 305-8509

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
I20131213000700 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2961639133 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT191203PAMDPediatrics Physician
MD261249-1NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Pediatrics CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2013 Accepting new patients
Trustees of Columbia University in the City of New York Pediatrics CurrentSince Jul 1, 2013 Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

3959 Broadway
#2N
New York, NY 10032
Phone (212) 305-8509

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 1624
New York, NY 10032
Phone (212) 305-4098

2026 Richmond Rd
Staten Island, NY 10306
Phone (212) 305-2300

Interoperability endpoints

  • Direct secure messaging: bra9015@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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, 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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1922298165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY # CH-2N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-8509",
            "fax_number": "212-305-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY # CH-2N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-8509",
            "fax_number": "212-305-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT191203",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "MD261249-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.