Enrique M. Bringas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036099834 Issued in IL

Practice address

615 Valley View Dr
Suite 201
Moline, IL 61265-6150

Phone

(309) 764-9404

Fax

(309) 764-9406

NPI assigned

Jun 30, 2005

Reactivated

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: enrique.bringas@direct.genesishealth.com

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.

• Genesis Health System

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945

  IL

  Medicare reassignment NPD
• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• Genesis Health System

  • Clinic/Center
  • Davenport, IA
  • NPI 1205860400
  NPD (past)
• Genesis Health System

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1124025531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "SUITE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224190",
            "telephone_number": "563-355-9191",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 VALLEY VIEW DR",
            "address_2": "SUITE 201",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656150",
            "telephone_number": "309-764-9404",
            "fax_number": "309-764-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINGAS",
        "first_name": "ENRIQUE",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036099834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "91287",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099834",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "067317",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H09474",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH PLANS",
            "identifier": "IL01E5",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4796890021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA HEALTH SOLUTIONS",
            "identifier": "510146",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enrique.bringas@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct  Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3900 28th Avenue Dr",
            "city": "Moline",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612655536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emiley Brand, DPT
• Bravard Chiropractic Inc
• Bravo Care of Moline Inc
• Brian Buckrop
• Brian J Anseeuw M.D. S.C.
• Amanda Christine Brissman, MSW
• Lisa Renee Britton, PSY.D.
• Anders J Brodd, MD
• John Cunningham Brooke, PH.D.
• Steven E Broomhead Jr., D.O.

• Family Medicine Physician in Moline, IL
• Providers in Moline, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.