NPIMap

Organization Active NPI

Brian Mayrsohn MD PLLC

  • Pain Medicine Physician
  • Port Jefferson, NY
National Provider Identifier
1942992235
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
BRIAN MAYRSOHN MD PLLC
Practice address
200 Belle Terre Rd Ste 300
Port Jefferson, NY 11777-1928
Phone
(631) 780-4470
Fax
(914) 366-6101
NPI assigned
May 24, 2023
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Deborah Stanco
Title
Administrator
Phone
(516) 458-0831

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

200 Belle Terre Rd Ste 300
Port Jefferson, NY 11777-1928

Mailing address

PO Box 2067
Oldsmar, FL 34677-7067
Phone (914) 366-6161

Other identifiers 1

IdentifierTypeStateIssuer
7502147MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230801003395 NY Part B Supplier - Clinic/Group Practice 9638530009 Receives reassigned benefits from 4 practitioners
Practice locations: New York, NY; Plainview, NY; Port Jefferson, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1942992235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2067",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346777067",
            "telephone_number": "914-366-6161",
            "fax_number": "914-366-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD STE 300",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771928",
            "telephone_number": "631-780-4470",
            "fax_number": "914-366-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN MAYRSOHN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "STANCO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-458-0831"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7502147",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.