Individual provider Active NPI

Carla Maria Brandt, M.D.

  • Neurology Physician
  • Evansville, IN
National Provider Identifier
1043210438
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01040814A Issued in IN
Practice address
1312 Professional Blvd Ste 201
Evansville, IN 47714-8019
Phone
(812) 476-7523
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 01040814A IN Primary

Addresses

Primary practice location

1312 Professional Blvd Ste 201
Evansville, IN 47714-8019

Mailing address

1312 Professional Blvd Ste 201
Evansville, IN 47714-8019

Other practice location 1

3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 476-7523

Other practice location 2

801 Saint Marys Dr Ste 400E
Evansville, IN 47714-0524
Phone (812) 476-7523

Other identifiers 1

IdentifierTypeStateIssuer
100329890AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carla.brandt.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20101201001158 IN Practitioner - Neurology 6507894433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Texas Medical Branch at Galveston, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

3700 Washington Ave
Evansville, IN 47714-0541

801 Saint Marys Dr
Evansville, IN 47714-0524

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, LLC CurrentSince Apr 1, 2024 Accepting new patients
St Mary'S Medical Group, LLC CurrentSince Apr 1, 2024 Accepting new patients
St. Mary'S Health, Inc Neurology Past Accepting new patients

Locations

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

1312 Professional Blvd
Ste 201
Evansville, IN 47714
Phone (812) 476-7523

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

801 Saint Marys Dr
Ste 400
Evansville, IN 47714
Phone (812) 477-0900

801 Saint Marys Dr
Ste 400E
Evansville, IN 47714
Phone (812) 476-7523

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 7

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1043210438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 PROFESSIONAL BLVD STE 201",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 PROFESSIONAL BLVD STE 201",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148019",
            "telephone_number": "812-476-7523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140541",
            "country_code": "US",
            "telephone_number": "812-476-7523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Saint Marys Dr Ste 400E",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140524",
            "country_code": "US",
            "telephone_number": "812-476-7523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "CARLA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01040814A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100329890A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carla.brandt.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "1312 Professional Blvd Ste 201",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477148019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.