Individual provider Active NPI

David Neil Brotman, MD

  • Surgery Physician
  • Paragould, AR
National Provider Identifier
1033112461
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E-11201 Issued in AR
Practice address
1000 W. Kingshighway
Suite 13
Paragould, AR 72450
Phone
(870) 239-8107
Fax
(870) 239-8115
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2012034742 MO
Surgery Physician 208600000X E-11201 AR Primary

Addresses

Primary practice location

1000 W. Kingshighway
Suite 13
Paragould, AR 72450

Mailing address

1000 W Kingshighway Ste 14
Paragould, AR 72450-4197
Phone (870) 239-8591

Other identifiers 1

IdentifierTypeStateIssuer
196413001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121213000086 MO Practitioner - General Surgery 1658460605 Reassigns benefits to 1 organization
I20180605003377 AR Practitioner - General Surgery 1658460605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Methodist Hospital CorporationGroup PAC ID 6608780119, 33 clinicians

Practice addresses (Care Compare)

1000 W Kingshighway
Paragould, AR 72450-4197

900 W Kingshighway
Paragould, AR 72450-5942

Hospital & facility affiliations

  • Arkansas Methodist Medical Center Hospital, Paragould, AR, CCN 040039

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-11201ARMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Bluff Hma Physician Management, LLC Surgery CurrentSince Feb 1, 2023 Accepting new patients
Arkansas Methodist Hospital Corporation Surgery CurrentSince Jun 1, 2020 Accepting new patients

Locations

900 W Kingshighway
Paragould, AR 72450
Phone (870) 239-7000

1000 W Kingshighway
Ste 14
Paragould, AR 72450
Phone (870) 239-7103

1000 W Kingshighway
Ste 13
Paragould, AR 72450
Phone (870) 239-5916

1000 W Kingshighway
Ste 7
Paragould, AR 72450
Phone (870) 236-8855

225 Physicians Park
Ste 204
Poplar Bluff, MO 63901
Phone (573) 712-2544

3098 Oak Grove Rd
Poplar Bluff, MO 63901
Phone (573) 778-2600

Interoperability endpoints

  • Direct secure messaging: david.brotman@ammcps.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GIECCA/Endpoint/GIECCA

Organizations & group practices 2

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 1

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1033112461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W KINGSHIGHWAY STE 14",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504197",
            "telephone_number": "870-239-8591",
            "fax_number": "870-239-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W. KINGSHIGHWAY",
            "address_2": "SUITE 13",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "72450",
            "telephone_number": "870-239-8107",
            "fax_number": "870-239-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTMAN",
        "first_name": "DAVID",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2012034742",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-11201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196413001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.