Individual provider Active NPI

Donielle Lynn Brasure, MPT

  • Physical Therapist
  • Millville, DE
National Provider Identifier
1023100641
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J10001969 Issued in DE
Practice address
232 Atlantic Ave
Millville, DE 19967-6728
Phone
(302) 539-3110
Fax
(302) 539-7237
NPI assigned
Sep 29, 2006
Last updated
Jul 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J10001969 DE Primary

Addresses

Primary practice location

232 Atlantic Ave
Millville, DE 19967-6728

Mailing address

232 Atlantic Ave
Millville, DE 19967-6728
Phone (302) 539-3110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000610 MD Practitioner - Physical Therapist in Private Practice 1658264197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AquaworxGroup PAC ID 4082891759, 8 clinicians

Practice addresses (Care Compare)

11204 Racetrack Rd
Suite 101
Berlin, MD 21811-3370
Phone (410) 208-1525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Konlian,O'Neill & Associates, P.a. Physical Therapist CurrentSince Jan 1, 2014 Accepting new patients
Aquaworx Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients
Bayside Physical Therapy, L.L.C. Physical Therapist Past Accepting new patients

Locations

11204 Racetrack Rd
Ste 101
Ocean Pines, MD 21811
Phone (410) 208-1525

106 Milford St
Ste 601
Salisbury, MD 21804
Phone (410) 548-7600

659 S Salisbury Blvd
Ste 1B
Salisbury, MD 21801
Phone (410) 831-3226

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1023100641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 ATLANTIC AVE",
            "city": "MILLVILLE",
            "state": "DE",
            "postal_code": "199676728",
            "telephone_number": "302-539-3110",
            "fax_number": "302-539-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 ATLANTIC AVE",
            "city": "MILLVILLE",
            "state": "DE",
            "postal_code": "199676728",
            "telephone_number": "302-539-3110",
            "fax_number": "302-539-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASURE",
        "first_name": "DONIELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10001969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millville, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.