Individual provider Active NPI

Angelle Brebnor, MD

  • Obstetrics & Gynecology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1013234590
Registry record updated Aug 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
FB7721651 Issued in FL
Practice address
4701 N Federal Hwy Ste B
Fort Lauderdale, FL 33308
Phone
(954) 229-6000
Fax
(954) 351-3782
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2743051 NY
Obstetrics & Gynecology Physician 207V00000X FB7721651 FL Primary

Addresses

Primary practice location

4701 N Federal Hwy Ste B
Fort Lauderdale, FL 33308

Mailing address

4701 N Federal Hwy Ste B
Fort Lauderdale, FL 33308-4608
Phone (954) 229-6000

Other practice location 1

219 Bryant St
Buffalo, NY 14222-2006
Phone (202) 487-6683

Other practice location 2

1001 Main St Fl 4
Buffalo, NY 14203-1009
Phone (716) 636-8284

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address angelle.brebnor@holy-cross.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20190130000113 FL Practitioner - Obstetrics/Gynecology 1254558935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Howard University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Holy Cross Medical Group
Oakland Park, FL 33334-4149
Phone (954) 489-4576

1000 NE 56TH St FL
2 Holy Cross Medical Group
Ft Lauderdale, FL 33334-4149
Phone (954) 958-0626

1000 NE 56TH St Womens Ctr
Holy Cross Medical Group
Ft Lauderdale, FL 33334-4149
Phone (954) 229-8660

1309 S Federal Hwy
Holy Cross Medical Group
Fort Lauderdale, FL 33316-2040
Phone (954) 463-4383

4725 N Fed Hwy
Ft. Lauderdale, FL 33308-4603
Phone (954) 771-8000

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 542-6000

4725 N Federal Hwy 201
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 565-5807

4725 N Federal Hwy 302
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 351-5931

4725 N Federal Hwy 401
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 772-2136

4725 N Federal Hwy 501
Holy Cross Medical Group
Fort Lauderdale, FL 33308-4603
Phone (954) 351-7770

4725 N Federal Hwy 504
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 414-9750

4725 N Federal Hwy Cancer Ctr
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-7700

4725 N Federal Hwy HCMG Multispecialty
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-6770

4725 N Federal Hwy Neuro Radiology
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5780

4725 N Federal Hwy Nuclear Medicine
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5748

4725 N Federal Hwy Pathology Departmen
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5728

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
274305NYMDLicensed Practical Nurse
2743051NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Inc Obstetrics & Gynecology CurrentSince Sep 1, 2018 Accepting new patients
Holy Cross Primary Care, Inc CurrentSince Jan 19, 2022 Accepting new patients
Holy Cross Hospital, Inc CurrentSince Sep 1, 2018 Accepting new patients

Locations

4701 N Federal Hwy
Ste B
Ft Lauderdale, FL 33308
Phone (954) 229-6000

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

Networks

  • FL HMO D-SNP
  • FL HMO C-SNP
  • FL HMO

Interoperability endpoints

  • Direct secure messaging: abrebnor2023640@direct.trinity-health.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629590400000",
    "number": "1013234590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 N FEDERAL HWY STE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084608",
            "telephone_number": "954-229-6000",
            "fax_number": "954-351-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 N FEDERAL HWY STE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-229-6000",
            "fax_number": "954-351-3782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Bryant St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142222006",
            "country_code": "US",
            "telephone_number": "202-487-6683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Main St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031009",
            "country_code": "US",
            "telephone_number": "716-636-8284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREBNOR",
        "first_name": "ANGELLE",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "2743051",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "FB7721651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angelle.brebnor@holy-cross.com",
            "affiliation": "N",
            "endpointDescription": "Holy Cross Hospital Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4701 N Federal Hwy Ste B",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.