Individual provider Active NPI

Vivian Judith Brasch, MD

  • Internal Medicine Physician
  • Brooksville, FL
National Provider Identifier
1144809039
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME168848 Issued in FL
Practice address
605 Lamar Ave
Brooksville, FL 34601-3211
Phone
(352) 796-9990
Fax
(352) 796-2226
NPI assigned
Apr 7, 2021
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME168848 FL Primary

Addresses

Primary practice location

605 Lamar Ave
Brooksville, FL 34601-3211

Mailing address

605 Lamar Ave
Brooksville, FL 34601-3211
Phone (352) 796-9990

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
I20240826002801 FL Practitioner - Internal Medicine 0244779924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Medical Specialists LLCGroup PAC ID 5799786687, shared by 2 NPIs, 125 clinicians
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

3844 Bee Ridge Rd
Sarasota, FL 34233-1163
Phone (941) 379-8481

605 Lamar Ave
Brooksville, FL 34601-3211
Phone (352) 796-9990

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Internal Medicine CurrentSince Sep 8, 2024 Accepting new patients
Optumcare Florida, LLC CurrentSince Sep 8, 2024 Accepting new patients
Wellmed Medical Management of Florida Inc Past Accepting new patients

Locations

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1260 S Broad St
Brooksville, FL 34601

605 Lamar Ave
Brooksville, FL 34601
Phone (352) 796-9990

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: vivian.brasch@wellmed.eclinicaldirectplus.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 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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1144809039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 LAMAR AVE",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346013211",
            "telephone_number": "352-796-9990",
            "fax_number": "352-796-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 LAMAR AVE",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346013211",
            "telephone_number": "352-796-9990",
            "fax_number": "352-796-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASCH",
        "first_name": "VIVIAN",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME168848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.