Individual provider Active NPI

Jean R Brown, N.P.

  • Adult Health Nurse Practitioner
  • Schenectady, NY
National Provider Identifier
1932179520
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
300222 Issued in NY
Practice address
1201 Nott Street
Suite 307
Schenectady, NY 12308-2589
Phone
(518) 243-3388
Fax
(518) 243-1329
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 300222 NY Primary
Family Nurse Practitioner 363LF0000X 331304 NY

Addresses

Primary practice location

1201 Nott Street
Suite 307
Schenectady, NY 12308-2589

Mailing address

1201 Nott Street
Suite 307
Schenectady, NY 12308-2589
Phone (518) 243-3388

Other identifiers 8

IdentifierTypeStateIssuer
500015186OtherNYRR MEDICARE
040426006783OtherNYFIDELIS
318476OtherNYMVP
000494228001OtherNYBLUE SHIELD
11464152OtherCAQH
0000000692111OtherNYGHI HMO
00347562MedicaidNY
7599230OtherNYPPOGHI

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
I20041012000992 NY Practitioner - Nurse Practitioner 7012977358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331304NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Sep 1, 2012 Accepting new patients

Locations

115 Saratoga Rd
Ste 200
Glenville, NY 12302
Phone (518) 243-3360

103 Sitterly Rd
Halfmoon, NY 12065
Phone (518) 579-2700

1201 Nott St
Ste 307
Schenectady, NY 12308
Phone (518) 243-3388

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1932179520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NOTT STREET",
            "address_2": "SUITE 307",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082589",
            "telephone_number": "518-243-3388",
            "fax_number": "518-243-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NOTT STREET",
            "address_2": "SUITE 307",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082589",
            "telephone_number": "518-243-3388",
            "fax_number": "518-243-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JEAN",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "300222",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "331304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500015186",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426006783",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "318476",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000494228001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11464152",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "0000000692111",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00347562",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOGHI",
            "identifier": "7599230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.