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ENNAJEE BRISBANE MD
NPI 1285322396
Student in an Organized Health Care Education/Training Program in Bronx, NY

Active since April 26, 2023PECOS Enrolled
111 E 210TH ST, BRONX, NY 10467(718) 920-4321 Get Directions Write a Review

NPPES record last updated: April 26, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Ennajee Brisbane Md NPPES

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

ENNAJEE BRISBANE MD (NPI 1285322396) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, is affiliated with Montefiore Medical Center, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1285322396
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameENNAJEE BRISBANECredential: MD
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address111 E 210th StBronx, NY 10467-2401 · (718) 920-4321
Phone(718) 920-4321
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateApril 26, 2023
NPPES CertifiedApril 26, 2023
✔ NPI 1285322396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
111 E 210TH ST, Bronx, NY 10467
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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)

Ennajee Brisbane Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254895998
PECOS Enrollment IDI20260714000418
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 Ennajee Brisbane reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Montefiore Medical Center
Same address
Anesthesiology
111 E 210TH ST
Bronx, NY 10467
  • Reassigned Medicare billing, New York enrollment
  • 5,251 clinicians in this Medicare group
NPI 1063525152 (914) 378-6021

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Montefiore Medical Center

Acute Care Hospitals · Bronx, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330059
Location111 East 210th StreetBronx, NY 10467 · Bronx County
Emergency services Birthing friendly

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.

HEATHER ROOT MD
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-8592
MICHAEL GOTTESMAN M.D.
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-5506
JIAE LEE M.D.
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
DR. MICHELLE DOMINIQUE PINTEA MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
TELISHA MCLEAN
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
SHIVADITYA CHOUDHURY
Anesthesiology
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
MS. JOHANNA SHEA-FEN TAN
Student in an Organized Health Care Education/Training Program
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
JACK DANIEL HALLIGAN MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321

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 Ennajee Brisbane's NPI number?

The NPI number for Ennajee Brisbane is 1285322396. It was assigned to this individual provider in the NPPES registry on April 26, 2023.

Where is Ennajee Brisbane located?

Ennajee Brisbane practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 920-4321.

What is Ennajee Brisbane's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ennajee Brisbane enrolled in Medicare?

Yes. Ennajee Brisbane is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ennajee Brisbane's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ennajee Brisbane reassigns Medicare benefits to Montefiore Medical Center (Bronx, 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 Ennajee Brisbane's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Ennajee Brisbane affiliated with any hospitals?

According to CMS data, Ennajee Brisbane is affiliated with Montefiore Medical Center.

When was this NPI record last updated?

The NPPES record for Ennajee Brisbane was last updated on April 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.