Individual provider Active NPI

Brianna Wynne, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Winter Park, FL
National Provider Identifier
1124559455
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME147648 Issued in FL
Practice address
133 Benmore Dr Ste 200
Winter Park, FL 32792-4111
Phone
(407) 599-6060
Fax
(407) 646-7747
NPI assigned
Mar 27, 2017
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WI
Family Medicine Physician 207Q00000X ME147648 FL
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME147648 FL Primary

Addresses

Primary practice location

133 Benmore Dr Ste 200
Winter Park, FL 32792-4111

Mailing address

133 Benmore Dr Ste 200
Winter Park, FL 32792-4111
Phone (407) 599-6060

Other practice location 1

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone (262) 532-3265

Other practice location 2

1600 SW Archer Rd
Gainesville, FL 32610-4002
Phone (352) 294-5800

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610000269 FL Practitioner - Geriatric MedicinePractitioner - Family Practice 1658610977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

133 Benmore Dr
Suite 200
Winter Park, FL 32792-4111
Phone (407) 599-7070

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME147648FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Family Medicine CurrentSince Jul 21, 2021 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 23, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 21, 2021 Accepting new patients

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

7975 Lake Underhill Rd
Ste 200
Orlando, FL 32822
Phone (407) 303-5990

133 Benmore Dr
Ste 200
Winter Park, FL 32792
Phone (407) 599-6060

Interoperability endpoints

  • Direct secure messaging: bwynne1501240@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1124559455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-599-6060",
            "fax_number": "407-646-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-599-6060",
            "fax_number": "407-646-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W180N8000 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530514002",
            "country_code": "US",
            "telephone_number": "262-532-3265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326104002",
            "country_code": "US",
            "telephone_number": "352-294-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "BRIANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME147648",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME147648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.