Individual provider Active NPI

Brandon Gerard Gaynor

  • Neurological Surgery Physician
  • Baton Rouge, LA
National Provider Identifier
1104068980
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
329615 Issued in LA
Practice address
10101 Park Rowe Ave Ste 200
Baton Rouge, LA 70810
Phone
(225) 769-2200
Fax
(225) 768-2185
NPI assigned
Mar 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 329615 LA Primary

Addresses

Primary practice location

10101 Park Rowe Ave Ste 200
Baton Rouge, LA 70810

Mailing address

10101 Park Rowe Ave Ste 200
Baton Rouge, LA 70810-1685
Phone (225) 769-2200

Other practice location 1

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-6565

Other identifiers 1

IdentifierTypeStateIssuer
329615OtherLALA MD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NJ, LA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20160715001982 IL Practitioner - Neurosurgery 2062704703 Reassigns benefits to 1 organization
I20191112000033 NJ Practitioner - Neurosurgery 2062704703 Reassigns benefits to 1 organization
I20220215001900 LA Practitioner - Neurosurgery 2062704703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Missouri, Kansas City, School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuromedical CenterGroup PAC ID 6103716477, 114 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-6565

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064
  • The Spine Hospital of Louisiana Hospital, Baton Rouge, LA, CCN 190266
  • Baton Rouge General Medical Center Hospital, Baton Rouge, LA, CCN 190065

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion90
Laminectomy or laminotomy (partial removal of spine bones)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
329615LAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Brain & Spine PC Neurological Surgery CurrentSince Dec 14, 2019 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Aug 1, 2016 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Neuromedical Center CurrentSince Apr 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 1, 2016 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

4400 W 95th St
Ste 407
Oak Lawn, IL 60453
Phone (708) 346-4062

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

10101 Park Rowe Ave
Ste 200
Baton Rouge, LA 70810
Phone (225) 768-2164

32 Philips Pkwy
Montvale, NJ 07645
Phone (201) 494-4479

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

Interoperability endpoints

  • Direct secure messaging: brandon.gaynor.1@25776.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1104068980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101685",
            "telephone_number": "225-769-2200",
            "fax_number": "225-768-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "225-769-2200",
            "fax_number": "225-768-2185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Hennessy Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084375",
            "country_code": "US",
            "telephone_number": "225-765-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "BRANDON",
        "middle_name": "GERARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "329615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA MD LICENSE",
            "identifier": "329615",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.