Individual provider Active NPI

Brandon Alan Pelletier, M.D.

  • Hospitalist Physician
  • Beloit, WI
National Provider Identifier
1114414307
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
81386-20 Issued in WI
Practice address
Beloit Health System Inc
1969 W Hart Road
Beloit, WI 53511-2230
Phone
(608) 363-5971
Fax
(608) 363-5737
NPI assigned
Apr 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 81386-20 WI
Hospitalist Physician 208M00000X 81386-20 WI Primary

Addresses

Primary practice location

Beloit Health System Inc
1969 W Hart Road
Beloit, WI 53511-2230

Mailing address

Beloit Health System Inc
1969 W Hart Road
Beloit, WI 53511-2230
Phone (608) 363-5971

Other practice location 1

2201 Hempstead Turnpike
East Meadow, NY 11554
Phone (516) 572-6501

Other identifiers 1

IdentifierTypeStateIssuer
100226955MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20230309001582 WI Practitioner - Internal Medicine 5597002998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, 138 clinicians

Practice addresses (Care Compare)

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 364-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81386-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System, Inc CurrentSince Mar 6, 2023 Accepting new patients
Beloit Clinic, S.C. Internal Medicine Current Accepting new patients
Beloit Health System Inc Internal Medicine CurrentSince Mar 6, 2023 Accepting new patients

Locations

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1114414307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BELOIT HEALTH SYSTEM INC",
            "address_2": "1969 W HART ROAD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-363-5971",
            "fax_number": "608-363-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BELOIT HEALTH SYSTEM INC",
            "address_2": "1969 W HART ROAD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-363-5971",
            "fax_number": "608-363-5737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Turnpike",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "11554",
            "country_code": "US",
            "telephone_number": "516-572-6501",
            "fax_number": "516-572-5609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "BRANDON",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2024-11-12",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "81386-20",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "81386-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100226955",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.