MARK BRENNAN DO NPI 1174523443

NPI Information

NPI: 1174523443
Provider Name: MARK BRENNAN, DO
Classification: Surgery - 2086S0129X
Specialization: Vascular Surgery
Entity Type: Individual
PECOS Registration: Yes
Address: 30 HARRISON ST
STE 455
JOHNSON CITY, NY
ZIP 13790
Phone: (607) 763-8100

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NPI Details

Mark Brennan, DO is a vascular surgery surgery in Johnson City, NY with 32 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Mark Brennan, DO NPI is 1174523443. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1994

The provider's business location address is:

30 HARRISON ST
STE 455
JOHNSON CITY, NY
ZIP 13790-161
Phone: (607) 763-8100
Fax: (607) 763-8048

The NPI 1174523443 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
Ultrasonic guidance for blood vessel access (HCPCS:76937)
Insertion of tunneled central venous tube for infusion (5 years or older) (HCPCS:36558)
Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
Hernia repair - groin (open) (HCPCS:NAN19)
Varicose vein removal (HCPCS:NAN08)
Leg revascularization (restoring blood flow) (HCPCS:NAN01)

The enumeration date for this NPI number is 7/28/2005 and was last updated on 9/15/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		217717	NEW YORK	No
2	2086S0129X	Surgery	Vascular Surgery	217717	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	CC0285	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
2	02082319	MEDICAID	NEW YORK
3	J400059224	MEDICARE PIN	NEW YORK
4	G61243	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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