Theodor Brockway, in New York, NY - Medicare Nurse Anesthetist, Certified Registered

Theodor Brockway, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in New York, New York. His current practice location is 550 1st Ave, New York, New York. You can reach out to his office (for appointments etc.) via phone at (212) 263-7300.

Theodor Brockway is licensed to practice in New York (license number 702059) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1902390693.

Contact Information

	Theodor Brockway,
	550 1st Ave, New York, NY 10016
	(212) 263-7300
	Not Available

Map and Direction

Provider's Profile

Full Name	Theodor Brockway
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	550 1st Ave, New York, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902390693
Provider Enumeration Date: 06/18/2018
Last Update Date: 08/09/2022

Medicare PECOS Information:

PECOS PAC ID: 9133472434
Enrollment ID: I20181105000233

Medical Identifiers

Medical identifiers for Theodor Brockway such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902390693	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	702059 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Theodor Brockway allows following entities to bill medicare on his behalf.

Entity Name	New York University
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851456701 PECOS PAC ID: 1355232422 Enrollment ID: O20040329001569

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theodor Brockway is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Theodor Brockway, 358 Lewis Ave Apt 2, Brooklyn, NY 11233-1118 Ph: (415) 630-0346	Theodor Brockway, 550 1st Ave, New York, NY 10016 Ph: (212) 263-7300

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in New York, NY

Steven Winnett, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 525 E 68th St, New York, NY 10065 Phone: 212-746-2962
Egbert Clayton, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1275 York Ave, New York, NY 10021 Phone: 646-227-3813
Nora Zmuidins, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1275 York Ave, New York, NY 10021 Phone: 646-227-3813
Ms. Lynn Ann Reilly, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 525 E 68th St, New York, NY 10065 Phone: 212-746-2959
Lauren Peiffer Selame, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1275 York Ave, New York, NY 10065 Phone: 212-639-2000
Sung Min Park, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 550 1st Ave, New York, NY 10016 Phone: 212-263-5072
Amanda M L Reuter, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 550 1st Ave, New York, NY 10016 Phone: 212-263-5072

Theodor Brockway, - Medicare Nurse Anesthetist, Certified Registered in New York, NY