Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theodor Brockway

Individual provider Certified Registered Nurse Anesthetist · NPI 1902390693

Theodor Brockway is registered under Certified Registered Nurse Anesthetist (CRNA) in New York, New York. Qualified in 2018, 8 years ago. Practices with Tuba City Regional Health Care Corporation, a 162-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
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Practice location Address checks out

550 1st Ave
New York, NY 10016
Phone: (212) 263-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 702059 (NY)

Record details

NPI number1902390693
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 18, 2018
Last updated in NPPESAugust 9, 2022
Certification dateAugust 9, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Tuba City Regional Health Care Corporation — 162 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients66
Services billed 68 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Tuba City Regional Health Care Corporation

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 162 clinicians in the practice; 12 are shown here.

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