Active NPI
Michael James Brennan, MD, MS
- Dermatology Physician
- Fort Pierce, FL
National Provider Identifier
1083415202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 4301517809
- Practice address
- 1700 S 23Rd St
Fort Pierce, FL 34950-4803 - Phone
- (772) 468-4554
- NPI assigned
- Mar 24, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 4301517809 | MI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1700 S 23Rd St
Fort Pierce, FL 34950-4803
Mailing address
4444 W Bristol Rd
Flint, MI 48507-3153
Phone (833) 322-3376
Other practice location 1
4444 W Bristol Rd
Flint, MI 48507-3153
Phone (833) 322-3376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250613003375 | FL | Order and Referring Only - Internal Medicine | 1759892094 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology & Cosmetic Center PLLC | Dermatology | Past | Accepting new patients |
Interoperability endpoints
- https://app.meldrx.com/api/fhir/ez_00340
- michael.brennan@hca4.eclinicaldirectplus.com
- michael.brennan.1@14627.direct.athenahealth.com
Organizations & group practices 1
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.
-
- Dermatology Physician
- Flint, MI
- NPI 1811605660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1083415202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4444 W BRISTOL RD",
"city": "FLINT",
"state": "MI",
"postal_code": "485073153",
"telephone_number": "833-322-3376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 S 23RD ST",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349504803",
"telephone_number": "772-468-4554"
}
],
"practiceLocations": [
{
"address_1": "4444 W Bristol Rd",
"address_purpose": "LOCATION",
"city": "Flint",
"state": "MI",
"postal_code": "485073153",
"country_code": "US",
"telephone_number": "833-322-3376",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRENNAN",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"credential": "MD, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-24",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "4301517809",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.