THEODOR BROCKWAY
NPI 1902390693
Nurse Anesthetist, Certified Registered in New York, NY

Active since June 18, 2018Accepts Medicare Assignment
84.47/100
CMS Quality Rating
550 1ST AVE, NEW YORK, NY 10016(212) 263-7300 Get Directions Write a Review

NPPES record last updated: August 9, 2022. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 9, 2022, Jun 18, 2018 (2 updates tracked since 2018).

About Theodor Brockway NPPES

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

THEODOR BROCKWAY (NPI 1902390693) is an individual nurse anesthetist, certified registered in New York, New York, licensed in New York (702059) and active in the NPI registry since June 2018. He is a graduate of Other (2018).

NPPES Registry Identity

NPI1902390693
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameTHEODOR BROCKWAY
Location Address550 1ST AVENew York, NY 10016
Mailing Address358 Lewis Ave Apt 2Brooklyn, NY 11233-1118 · (415) 630-0346
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateJune 18, 2018
Last NPPES UpdateAugust 9, 20222 updates tracked since enumeration
NPPES CertifiedAugust 9, 2022
NPI 1902390693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in NY · 702059
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
550 1ST AVE, New York, NY 10016

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Theodor Brockway is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133472434
PECOS Enrollment IDI20240308003707

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.33
Promoting Interoperability100
Improvement Activities40
Cost54.91

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.

Internal Medicine
550 1ST AVE
NEW YORK, NY 10016
Emergency Medicine (Pediatric Emergency Medicine)
550 1ST AVE
NEW YORK, NY 10016
Allergy & Immunology
550 1ST AVE, NBV 16N30, INTERNAL MEDICINE RESIDENCY PROGRAM
NEW YORK, NY 10016
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
Radiology (Vascular & Interventional Radiology)
550 1ST AVE
NEW YORK, NY 10016
Surgery
550 1ST AVE
NEW YORK, NY 10016
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016
Student in an Organized Health Care Education/Training Program
550 1ST AVE
NEW YORK, NY 10016

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 Theodor Brockway's NPI number?

The NPI number for Theodor Brockway is 1902390693. It was assigned to this individual provider in the NPPES registry on June 18, 2018.

Where is Theodor Brockway located?

Theodor Brockway practices at 550 1st Ave, New York, NY 10016. The listed phone number is (212) 263-7300.

What is Theodor Brockway's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Theodor Brockway enrolled in Medicare?

Yes. Theodor Brockway is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodor Brockway accept?

Health plans from Blue Cross and Blue Shield of Texas and CareSource list Theodor Brockway 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 Theodor Brockway was last updated on August 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.