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 a 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
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

550 1st Ave
New York, NY 10016
Phone: (212) 263-7300
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Other providers in New York