Jeff S Brent, M.D.

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

MD60549416 Issued in WA

Practice address

700 NE 87TH Ave
Vancouver, WA 98664-1913

Phone

(360) 882-2778

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Georgia Regents University College of Dental Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbrent9472@tvc-direct.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Vancouver Clinic Inc PS

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment Care Compare group
• The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
  • NPI 1760004477
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1013124734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 873010",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986873010",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENT",
        "first_name": "JEFF",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD60549416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas A Breitenbauch
• Trista Faye Breitenbauch, SUDP
• Amanda Pauline Breland
• Laurence F. Brennan, MSW
• Preston Brennan
• Erick Rogelio Breton-Guillen, B.A
• Taryn Alyssa Brewer
• Chelsea Louise Brewster, PHARMD
• Clinton Brewster
• Nakaycia Shelisa Brewton, MSW, LCSW

• Sports Medicine (Emergency Medicine) Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Sports Medicine (Emergency Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.