Individual provider Active NPI

Brandon Ithiel Esianor, MD

  • Otolaryngology Physician
  • Marshfield, WI
National Provider Identifier
1083111645
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
104102 Issued in WI
Practice address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone
(715) 387-5511
NPI assigned
Apr 10, 2018
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 91595 SC
Otolaryngology Physician 207Y00000X 327014 NY
Otolaryngology Physician 207Y00000X 104102 WI Primary
Pediatric Otolaryngology Physician 207YP0228X 91595 SC

Addresses

Primary practice location

1000 N Oak Ave
Marshfield, WI 54449-5703

Mailing address

PO Box 751461
Charlotte, NC 28275-1461

Other practice location 1

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-1414

Other practice location 2

6701 Fannin St Floor 5
Houston, TX 77030-8605
Phone (832) 822-3250

Other practice location 3

9618 Huebner Rd
San Antonio, TX 78240-1660
Phone (210) 358-4583

Other practice location 4

16723 Huebner Rd
San Antonio, TX 78248-2351
Phone (210) 644-3600

Other practice location 5

1015 Spring St
Greenwood, SC 29646-3831
Phone (864) 227-6741

Other identifiers 1

IdentifierTypeStateIssuer
915950MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NY2 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
I20240625002012 SC Practitioner - Otolaryngology 3779026232 Reassigns benefits to 2 organizations
I20260421000543 NY Practitioner - Otolaryngology 3779026232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Harrison St
Suite 355
Johnson City, NY 13790-2162
Phone (607) 770-1018

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327014NYMDOtolaryngology Physician
91595SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 1, 2024 Accepting new patients
Self Medical Group CurrentSince May 15, 2025 Accepting new patients
Self Medical Group CurrentSince May 15, 2025 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 1, 2024 Accepting new patients
Self Medical Group Current Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

1015 Spring St
Greenwood, SC 29646
Phone (864) 227-6741

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: besianor226761@direct-guthrie.org
  • Direct secure messaging: besianor486114@direct.musc.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1083111645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6701 Fannin St Floor 5",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770308605",
            "country_code": "US",
            "telephone_number": "832-822-3250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9618 Huebner Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782401660",
            "country_code": "US",
            "telephone_number": "210-358-4583",
            "fax_number": "210-358-0510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16723 Huebner Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782482351",
            "country_code": "US",
            "telephone_number": "210-644-3600",
            "fax_number": "210-702-6963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Spring St",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296463831",
            "country_code": "US",
            "telephone_number": "864-227-6741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESIANOR",
        "first_name": "BRANDON",
        "middle_name": "ITHIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "91595",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "327014",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "104102",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "SC",
            "license": "91595",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "915950",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.