NPIMap

Individual provider Active NPI

Kiri Pryjma Brandy, M.D.

  • Surgery Physician
  • Canton, NY
National Provider Identifier
1972763746
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
248313 Issued in NY
Practice address
80 E Main St
Canton, NY 13617
Phone
(315) 261-5934
NPI assigned
Jun 14, 2008
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 248313 NY
Surgery Physician 208600000X 248313 NY Primary

Addresses

Primary practice location

80 E Main St
Canton, NY 13617

Mailing address

50 Leroy St
Potsdam, NY 13676-1799
Phone (315) 265-3300

Other practice location 1

305 Main Street
Ogdensburg, NY 13669
Phone (315) 393-2611

Other identifiers 1

IdentifierTypeStateIssuer
02982878MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbrandy333259@direct.rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000384 NY Practitioner - General Surgery 2264507292 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Hospital IncGroup PAC ID 2567372899, 36 clinicians
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

4 Fuller St
Alex Bay, NY 13607-1316
Phone (315) 482-2511

80 E Main St
Canton, NY 13617-1450
Phone (315) 386-3300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy87
Mastectomy22
Upper gastrointestinal (GI) endoscopy for acid reflux48
Varicose vein removal14
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
River Hospital, Inc. CurrentSince Jun 11, 2019 Accepting new patients
Canton-Potsdam Hospital CurrentSince Sep 1, 2020 Accepting new patients
Gouverneur Hospital CurrentSince Sep 1, 2020 Accepting new patients
Canton-Potsdam Hospital Current Accepting new patients
Gouverneur Hospital CurrentSince Sep 1, 2020 Accepting new patients
River Hospital, Inc. CurrentSince Jun 11, 2019 Accepting new patients
Canton-Potsdam Hospital CurrentSince Sep 1, 2020 Accepting new patients
Claxton-Hepburn Medical Center CurrentSince Jan 1, 2023 Accepting new patients
Gouverneur Hospital Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

4 Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-1277

39 W Main St
Canton, NY 13617
Phone (315) 379-4700

80 E Main St
Canton, NY 13617
Phone (315) 261-6034

214 King St
Ogdensburg, NY 13669
Phone (315) 713-5660

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1972763746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761799",
            "telephone_number": "315-265-3300",
            "fax_number": "315-393-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E MAIN ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "13617",
            "telephone_number": "315-261-5934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Main Street",
            "address_purpose": "LOCATION",
            "city": "Ogdensburg",
            "state": "NY",
            "postal_code": "13669",
            "country_code": "US",
            "telephone_number": "315-393-2611",
            "fax_number": "315-393-2633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDY",
        "first_name": "KIRI",
        "middle_name": "PRYJMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-14",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "248313",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "248313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02982878",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbrandy333259@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "80 E Main St",
            "city": "Canton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "13617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

Verify at the official NPI Registry.