BROCKPORT ASAP MEDICAL CARE
NPI 1477996353
Clinic/Center - Urgent Care in Brockport, NY
About Brockport Asap Medical Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROCKPORT ASAP MEDICAL CARE (NPI 1477996353) is a healthcare organization registered as an urgent care in Brockport, New York and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Hany G Nissiem, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brockport Asap Medical Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Brockport Asap Medical Care, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 33D2060532
Brockport Medical Care, PLLC · Brockport, NYFrequently 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 Brockport Medical Care PLLC's NPI number?
The NPI number for Brockport Medical Care PLLC is 1477996353. It was assigned to this organization in the NPPES registry on April 10, 2013. The provider is doing business as Brockport Asap Medical Care.
Where is Brockport Medical Care PLLC located?
Brockport Medical Care PLLC is located at 6565 4th Section Rd Suite 100, Brockport, NY 14420. The listed phone number is (585) 637-7006.
What is Brockport Medical Care PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.
Is Brockport Medical Care PLLC enrolled in Medicare?
Yes. Brockport Medical Care PLLC is registered in the Medicare PECOS enrollment system.
When is Brockport Medical Care PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Brockport Medical Care PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Brockport Medical Care PLLC, in Emergency Medicine, Family Practice and Nurse Practitioner. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Brockport Medical Care PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2060532) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Brockport Medical Care PLLC was last updated on April 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Brockport Asap Medical Care · NPI 1477996353
Urgent Care organization in Brockport, New York. Organization record, active in the CMS NPPES registry since April 10, 2013.
## Identity
- **NPI:** 1477996353 (Entity type: Organization)
- **Enumerated:** April 10, 2013
- **Primary specialty:** Clinic/Center - Urgent Care · taxonomy 261QU0200X
- **Legal business name:** Brockport Medical Care Pllc
- **Organization subpart:** No
- **Authorized official:** Hany Nissiem, PRESIDENT
## Practice location
- **Address:** 6565 4TH SECTION RD, SUITE 100, Brockport, NY 14420-2414
- **Phone:** (585) 637-7006
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Emergency Medicine (1), Nurse Practitioner (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 10, 2013
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1477996353) · Data from the CMS NPPES public registry.