Individual provider Active NPI

Michael James Brennan, MD, MS

  • Dermatology Physician
  • Fort Pierce, FL
National Provider Identifier
1083415202
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301517809 Issued in MI
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

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250613003375 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1759892094

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology & Cosmetic Center PLLC Dermatology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00340
  • Direct secure messaging: michael.brennan@hca4.eclinicaldirectplus.com
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.