NPIMap

Individual provider Active NPI

Marvin Donald Brauer, M.D.

  • Hospitalist Physician
  • Redlands, CA
National Provider Identifier
1043219314
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
G156438 Issued in CA
Practice address
2 W Fern Ave
Redlands, CA 92373
Phone
(909) 793-3311
NPI assigned
Jul 19, 2005
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101045088 VA
Hospitalist Physician 208M00000X G156438 CA Primary

Addresses

Primary practice location

2 W Fern Ave
Redlands, CA 92373

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other identifiers 2

IdentifierTypeStateIssuer
006037011MedicaidVA
068517OtherVABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101045088VAMDInternal Medicine Physician
G156438CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Family Resources P C Past Accepting new patients
Primedoc Park Ridge PA Internal Medicine Past Accepting new patients
Primedoc of Seneca PA Internal Medicine Past Accepting new patients
Primedoc of Winchester PC Internal Medicine Past Accepting new patients
Harris Regional Hospital Inc Hospitalist Past Accepting new patients
Capital Eye Care, Doctors of Optometry, PC Past Accepting new patients
Primedoc of Norfolk PC Internal Medicine Past Accepting new patients
Primedoc of Richmond PC Internal Medicine Past Accepting new patients
WNC Hospitalist Service PLLC Internal Medicine Past Accepting new patients

Organizations & group practices 9

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1043219314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W FERN AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-793-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUER",
        "first_name": "MARVIN",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101045088",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "G156438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006037011",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "068517",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.