BRANDEIS BROCKMAN CRNP
NPI 1114289402
Nurse Practitioner - Family in Bala Cynwyd, PA
About Brandeis Brockman Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRANDEIS BROCKMAN CRNP (NPI 1114289402) is an individual family provider in Bala Cynwyd, Pennsylvania, licensed in Pennsylvania (SP012117) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brandeis Brockman Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Brandeis Brockman reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Philadelphia, PA 19102
- Reassigned Medicare billing, Pennsylvania enrollment
- 100 clinicians in this Medicare group
Philadelphia, PA 19104
- Reassigned Medicare billing, Pennsylvania enrollment
- 752 clinicians in this Medicare group
Dallas, TX 75244
- Reassigned Medicare billing, Pennsylvania enrollment
- 553 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BALA CYNWYD, PA 19004
BALA CYNWYD, PA 19004
BALA CYNWYD, PA 19004
BALA CYNWYD, PA 19004
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Brandeis Brockman's NPI number?
The NPI number for Brandeis Brockman is 1114289402. It was assigned to this individual provider in the NPPES registry on June 12, 2012.
Where is Brandeis Brockman located?
Brandeis Brockman practices at 15 Presidential Blvd, Bala Cynwyd, PA 19004. The listed phone number is (610) 668-8300.
What is Brandeis Brockman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Brandeis Brockman enrolled in Medicare?
Yes. Brandeis Brockman is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Brandeis Brockman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brandeis Brockman reassigns Medicare benefits to 3 organizations: Public Health Management Corporation (Philadelphia, PA), University Of Penn-Medical Group (Philadelphia, PA) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brandeis Brockman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Brandeis Brockman accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Brandeis Brockman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Brandeis Brockman was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Brandeis Brockman, CRNP · NPI 1114289402
Family physician in Bala Cynwyd, Pennsylvania. Individual provider, active in the CMS NPPES registry since June 12, 2012.
## Identity
- **NPI:** 1114289402 (Entity type: Individual)
- **Enumerated:** June 12, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** SP012117 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 15 PRESIDENTIAL BLVD, Bala Cynwyd, PA 19004-1006
- **Phone:** (610) 668-8300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Public Health Management Corporation (NPI 1932245099, Philadelphia, PA); University Of Penn-Medical Group (NPI 1386751089, Philadelphia, PA); Signify Health Medical Associates, PLLC (NPI 1750845863, Dallas, TX) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1114289402) · Data from the CMS NPPES public registry.