Individual provider Active NPI

Anand Brahmamdam, DO

  • Diagnostic Radiology Physician
  • St Francis, WI
National Provider Identifier
1063830784
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
65274 Issued in WI
Practice address
2000 E Layton Ave
St Francis, WI 53235-6053
Phone
(414) 744-6589
NPI assigned
Mar 31, 2014
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 65274 WI Primary
Diagnostic Radiology Physician 2085R0202X OS16633 FL
Neuroradiology Physician 2085N0700X 036.148128 IL
Neuroradiology Physician 2085N0700X OS16633 FL

Addresses

Primary practice location

2000 E Layton Ave
St Francis, WI 53235-6053

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1490 SE Magnolia Ext
Ocala, FL 34471-4499
Phone (352) 732-7400

Other practice location 2

251 E Huron St
Chicago, IL 60611-2908
Phone (312) 695-1292

Other practice location 3

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-3323

Other identifiers 1

IdentifierTypeStateIssuer
100063575MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address abrahmamdam116067@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WI2 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
I20200519001296 FL Practitioner - Diagnostic Radiology 6800129511 Reassigns benefits to 4 organizations
I20231026001324 WI Practitioner - Diagnostic Radiology 6800129511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

W231 N1440 Corporate Court
Waukesha, WI 53186-1303
Phone (262) 896-6070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65274WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Sep 11, 2023 Accepting new patients
Ocala Health Imaging Services LLC Diagnostic Radiology CurrentSince Aug 1, 2020 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology CurrentSince Sep 11, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 11, 2023 Accepting new patients
St. Anthony's Professional Buildings & Services, Inc Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
St. Anthony's Professional Buildings & Services, Inc Current Accepting new patients
St Thomas Radiology Associates LLC Neuroradiology CurrentSince Oct 23, 2020 Accepting new patients
St. Anthony's Professional Buildings & Services, Inc Diagnostic Radiology CurrentSince Aug 9, 2021 Accepting new patients
Radiology Associates of St. Petersburg PA Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Medical Imaging Center of Ocala LLP Diagnostic Radiology PastSince Feb 11, 2024 Accepting new patients
St. Thomas Radiology Associates, LLC Diagnostic Radiology Past Accepting new patients

Locations

1490 SE Magnolia Ext
Ocala, FL 34471
Phone (352) 512-9703

2300 SE 17th St
Ste 800
Ocala, FL 34471
Phone (352) 690-8403

9521 SW Highway 200
Ocala, FL 34481
Phone (352) 351-7500

1041 Dunlawton Ave
Pt Orange, FL 32127
Phone (386) 322-4700

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

1201 5th Ave N
St Petersburg, FL 33705
Phone (727) 821-1132

620 10th St N
Ste 100
St Petersburg, FL 33705
Phone (727) 502-4200

900 Carillon Pkwy
St Petersburg, FL 33716
Phone (727) 556-2662

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: abrahmamdam116067@direct.myadvocateaurora.org

Organizations & group practices 13

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.

View all 13

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1063830784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAYTON AVE",
            "city": "ST FRANCIS",
            "state": "WI",
            "postal_code": "532356053",
            "telephone_number": "414-744-6589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 SE Magnolia Ext",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344714499",
            "country_code": "US",
            "telephone_number": "352-732-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112908",
            "country_code": "US",
            "telephone_number": "312-695-1292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154330",
            "country_code": "US",
            "telephone_number": "414-649-3323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAHMAMDAM",
        "first_name": "ANAND",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "65274",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS16633",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036.148128",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "FL",
            "license": "OS16633",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100063575",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abrahmamdam116067@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Francis, WI

Sources for this page

Verify at the official NPI Registry.