Individual provider Active NPI

Jacqueline Irene Brand, M.D.

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1073976940
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301117575 Issued in MI
Practice address
2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Phone
(313) 916-2600
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 4301117575 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Phone (313) 916-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190710001157 MI Practitioner - Emergency Medicine 4486989647 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Feb 1, 2022 Accepting new patients
Vituity - Michigan Em PC Emergency Medicine CurrentSince Oct 29, 2021 Accepting new patients
Henry Ford Health System Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Henry Ford Health System Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Interoperability endpoints

  • Direct secure messaging: jbrand369292@direct.hfhs.org

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1073976940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "JACQUELINE",
        "middle_name": "IRENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301117575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.