Active NPI
David Neil Brotman, MD
- Surgery Physician
- Paragould, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- E-11201
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196413001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-11201 | AR | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poplar Bluff Hma Physician Management, LLC | Surgery | Current | Accepting new patients |
| Arkansas Methodist Hospital Corporation | Surgery | Current | 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
- david.brotman@ammcps.eclinicaldirectplus.com
- 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.
-
- Otolaryngology Physician
- Paragould, AR
- NPI 1205457405
Surgery
-
- Family Medicine Physician
- Poplar Bluff, MO
- NPI 1598710147
Surgery
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Paragould, AR
- NPI 1437222312
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.