Individual provider Active NPI

Joan Sirelle Brenner, CNM

  • Advanced Practice Midwife
  • Rochester, NY
National Provider Identifier
1952366098
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000054 Issued in NY
Practice address
500 Helendale Rd
Lle-10
Rochester, NY 14609-3173
Phone
(585) 266-1220
Fax
(585) 266-1227
NPI assigned
Apr 20, 2006
Last updated
Mar 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F000054 NY Primary

Addresses

Primary practice location

500 Helendale Rd
Lle-10
Rochester, NY 14609-3173

Mailing address

500 Helendale Rd
Lle-10
Rochester, NY 14609-3173
Phone (585) 266-1220

Other identifiers 3

IdentifierTypeStateIssuer
01973422MedicaidNY
102982CQOtherPREFERRED CARD
P010316528OtherBL CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140324000525 NY Practitioner - Certified Nurse Midwife (CNM) 3678556446 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000045NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Trillium Health, Inc CurrentSince Aug 4, 2019 Accepting new patients
Trillium Health, Inc CurrentSince Aug 4, 2019 Accepting new patients
Jacquelyn Cullen Howitt MD PLLC PastSince Mar 25, 2010 Accepting new patients
Dinolfo Urban LLP Past Accepting new patients
Anesthesia Associates of Rochester, P.C. Past Accepting new patients

Locations

259 Monroe Ave
Rochester, NY 14607
Phone (585) 325-2280

Organizations & group practices 5

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1952366098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HELENDALE RD",
            "address_2": "LLE-10",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093173",
            "telephone_number": "585-266-1220",
            "fax_number": "585-266-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HELENDALE RD",
            "address_2": "LLE-10",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146093173",
            "telephone_number": "585-266-1220",
            "fax_number": "585-266-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "JOAN",
        "middle_name": "SIRELLE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01973422",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED  CARD",
            "identifier": "102982CQ",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BL CHOICE",
            "identifier": "P010316528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.