Individual provider Active NPI

Brittani Imbrie, PA-C

  • Physician Assistant
  • Carle Place, NY
National Provider Identifier
1952716151
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020754 Issued in NY
Practice address
235 Glen Cove Rd
Carle Place, NY 11514-1221
Phone
(516) 877-2273
Fax
(516) 877-2275
NPI assigned
Jun 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA056897 PA
Student in an Organized Health Care Education/Training Program 390200000X MA056897 PA
Physician Assistant 363A00000X 020754 NY Primary

Addresses

Primary practice location

235 Glen Cove Rd
Carle Place, NY 11514-1221

Mailing address

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Other names 1

  • Brittani Raybuck Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160113002276 PA Practitioner - Physician Assistant 0244532893 Reassigns benefits to 1 organization
I20200420000014 CO Practitioner - Physician Assistant 0244532893 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA056897PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Community Emergency Services of Colorado, Inc. CurrentSince Nov 15, 2021 Accepting new patients
Einstein Practice Plan Inc CurrentSince Dec 1, 2015 Accepting new patients
Usacs of Colorado, Inc CurrentSince May 15, 2020 Accepting new patients
Usacs Community Emergency Services of Colorado, Inc. CurrentSince Nov 15, 2021 Accepting new patients
Usacs Observation Medicine Services of Colorado, Inc. CurrentSince Jul 16, 2020 Accepting new patients
Usacs of Colorado Inc CurrentSince May 15, 2020 Accepting new patients
Einstein Practice Plan, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Premier Emergency Services, Inc CurrentSince Mar 31, 2020 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Jul 16, 2020 Accepting new patients

Locations

16320 W 64th Ave
Arvada, CO 80007
Phone (303) 925-4560

7000 E Hampden Ave
Denver, CO 80224
Phone (330) 925-4199

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

2551 W 84th Ave
Westminster, CO 80031
Phone (303) 202-1280

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1952716151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 GLEN COVE RD",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141221",
            "telephone_number": "516-877-2273",
            "fax_number": "516-877-2275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMBRIE",
        "first_name": "BRITTANI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056897",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MA056897",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANI",
            "last_name": "RAYBUCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carle Place, NY

Sources for this page

Verify at the official NPI Registry.