Individual provider Active NPI

Breanna J. Ferguson, D.P.M.

  • Podiatrist
  • Tavares, FL
National Provider Identifier
1114304425
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO4013 Issued in FL
Practice address
870 S Duncan Dr
Tavares, FL 32778-4044
Phone
(352) 432-8434
NPI assigned
May 6, 2015
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO4013 FL Primary

Addresses

Primary practice location

870 S Duncan Dr
Tavares, FL 32778-4044

Mailing address

870 S Duncan Dr
Tavares, FL 32778-4044
Phone (352) 432-8434

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824000118 FL Practitioner - Podiatry 4688923667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

870 S Duncan Dr
Tavares, FL 32778-4044
Phone 3524328434101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue308
Removal of skin lesions41
Removal of nail tissue1015
Removal or shaving of skin growth383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yhn 1, LLC Podiatrist CurrentSince May 7, 2023 Accepting new patients
O W S Medical, LLC Podiatrist CurrentSince Jun 11, 2018 Accepting new patients
O W S Medical LLC Podiatrist CurrentSince Apr 1, 2019 Accepting new patients

Locations

3651 Lake Center Dr
Mount Dora, FL 32757
Phone (352) 385-9156

870 S Duncan Dr
Tavares, FL 32778
Phone (352) 432-8434

Interoperability endpoints

  • Direct secure messaging: breannajferguson@hds11802.ssdirect.aprima.com

Organizations & group practices 3

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 3

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1114304425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 S DUNCAN DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784044",
            "telephone_number": "352-432-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 S DUNCAN DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784044",
            "telephone_number": "352-432-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "BREANNA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.