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BREANNA LEE FELLDIN MD
NPI 1114556628
Psychiatry & Neurology - Child & Adolescent Psychiatry in Syracuse, NY

Active since April 06, 2020PECOS Enrolled
719 HARRISON ST, SYRACUSE, NY 13210(315) 464-3265(315) 464-3282 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 24, 2025, Apr 6, 2020 (2 updates tracked since 2020).

About Breanna Lee Felldin Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREANNA LEE FELLDIN MD (NPI 1114556628) is an individual child & adolescent psychiatry provider in Syracuse, New York, licensed in New York (331782) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114556628
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameBREANNA LEE FELLDINCredential: MD
Location Address719 HARRISON STSyracuse, NY 13210-2695
Mailing Address719 Harrison StSyracuse, NY 13210-2695 · (315) 464-3265 · Fax (315) 464-3282
Phone(315) 464-3265
Fax(315) 464-3282
Sole ProprietorYes
Enumeration DateApril 6, 2020
Last NPPES UpdateJune 24, 20252 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
✔ NPI 1114556628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in NY · 331782
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 331782 (NY)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
719 HARRISON ST, Syracuse, NY 13210
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Breanna Lee Felldin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Breanna Felldin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psychiatry Faculty Practice, Inc.
Same address
Psychiatry
713 HARRISON ST
Syracuse, NY 13210
  • Reassigned Medicare billing, New York enrollment
  • 171 clinicians in this Medicare group
NPI 1881084820 (315) 464-3119

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WURAOLA SOFOWOTE
Nurse Practitioner (Psychiatric/Mental Health)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3265
DR. MADISON FIRKEY PHD
Psychologist
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3265
RAJAE ELKIRAMI RN, PMHNP, BCNP
Nurse Practitioner (Psychiatric/Mental Health)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3103
DEVON OOSTING PHD
Psychologist (Clinical Child & Adolescent)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3265
DUQUINHA THOMPSON
Counselor (Mental Health)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-5540
KAYLIN SHAYE PELOTENIA PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3265
MS. TAMMY L BALAMUT NP (PSYCHIATRIC NP)
Nurse Practitioner (Psychiatric/Mental Health)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3265
KAYLA GRIMES MSN, RN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
719 HARRISON ST
SYRACUSE, NY 13210
Onondaga County (315) 464-3265

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 Breanna Felldin's NPI number?

The NPI number for Breanna Felldin is 1114556628. It was assigned to this individual provider in the NPPES registry on April 6, 2020.

Where is Breanna Felldin located?

Breanna Felldin practices at 719 Harrison St, Syracuse, NY 13210. The listed phone number is (315) 464-3265.

What is Breanna Felldin's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Breanna Felldin enrolled in Medicare?

Yes. Breanna Felldin is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Breanna Felldin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Breanna Felldin reassigns Medicare benefits to Psychiatry Faculty Practice, Inc. (Syracuse, NY). The 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 Breanna Felldin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Breanna Felldin was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.