Individual provider Active NPI

Brenna K Gerdelman, MD

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1033125380
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L8793 Issued in TX
Practice address
5145 FM 620 N BLDG I
Austin, TX 78732-1839
Phone
(512) 681-5901
Fax
(512) 681-5921
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L8793 TX Primary

Addresses

Primary practice location

5145 FM 620 N BLDG I
Austin, TX 78732-1839

Mailing address

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 681-5901

Other identifiers 4

IdentifierTypeStateIssuer
186540403MedicaidTX
186540401MedicaidTX
P01456795OtherRRMC PTAN
186540402MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BRENNA.GERDELMAN@hca8.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070419000239 TX Practitioner - Family Practice 7214835487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-2530

2400 Cedar Bend Dr
Austin, TX 78758-5378
Phone (512) 901-4011

5145 FM 620
Austin, TX 78732-1815
Phone (512) 681-5960

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.64 of 100Reported as individual
Quality
89.04
Promoting interoperability
100
Improvement activities
40
Cost
63.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L8793TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Austin Diagnostic Clinic, PLLC CurrentSince Mar 5, 2014 Accepting new patients
The Austin Diagnostic Clinic, PLLC Current Accepting new patients
Austin Diagnostic Clinic CurrentSince Mar 5, 2014 Accepting new patients
Austin Diagnostic Clinic, PA Past Accepting new patients
The Austin Diagnostic Clinic, PLLC PastSince Feb 1, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

5145 FM 620 N
Bldg 1
Austin, TX 78732
Phone (512) 338-0492

5145 Ranch Road 620 N
Bldg I
Austin, TX 78732
Phone (512) 681-5900

4315 James Casey St
Austin, TX 78745
Phone (512) 460-3404

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

5145 Ranch Road 620 N
Austin, TX 78732
Phone (512) 266-1392

Interoperability endpoints

  • Direct secure messaging: 11219-gerdelman-brenna@direct.leadingreach.com
  • Direct secure messaging: brenna.gerdelman@hca8.eclinicaldirectplus.com

Organizations & group practices 5

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 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1033125380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-681-5901",
            "fax_number": "512-681-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 FM 620 N BLDG I",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321839",
            "telephone_number": "512-681-5901",
            "fax_number": "512-681-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERDELMAN",
        "first_name": "BRENNA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186540403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186540401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC PTAN",
            "identifier": "P01456795",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186540402",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BRENNA.GERDELMAN@hca8.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5145 Fm 620 N Bldg I",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787321839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.