NPIMap

Individual provider Active NPI

Matthew J Brennan, MD

  • Obstetrics & Gynecology Physician
  • Grand Island, NE
National Provider Identifier
1104826155
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21693 Issued in NE
Practice address
2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone
(308) 382-1100
Fax
(308) 385-0796
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21693 NE Primary

Addresses

Primary practice location

2444 W Faidley Ave
Grand Island, NE 68803-4327

Mailing address

PO Box 550
Grand Island, NE 68802-0550
Phone (308) 382-1100

Other identifiers 4

IdentifierTypeStateIssuer
47017633016MedicaidNE
35449OtherNEBCBS
232439OtherNEMIDLANDS CHOICE
160052887OtherNEPALMETTO GBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100614000167 NE Practitioner - Obstetrics/Gynecology 1052497013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Island Clinic IncGroup PAC ID 9931181526, 22 clinicians

Practice addresses (Care Compare)

2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone (308) 382-1100

Hospital & facility affiliations

  • CHI Health St. Francis Hospital, Grand Island, NE, CCN 280023
  • Grand Island Regional Medical Center Hospital, Grand Island, NE, CCN 280139
  • Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Island Clinic Inc Obstetrics & Gynecology CurrentSince Aug 1, 2001 Accepting new patients
Grand Island Clinic Inc Past Accepting new patients
Grand Island Regional Medical Center Past Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

2444 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-1100

Interoperability endpoints

  • Direct secure messaging: matthewbrennan@gici.allscriptsdirect.net

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.

Hospital & facility affiliations 4

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1104826155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688020550",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034327",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "21693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47017633016",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35449",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "232439",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "160052887",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.