Active NPI
David R Brandau, M.D.
- Obstetrics & Gynecology Physician
- Canton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 35-039711
- Practice address
- 4151 Holiday St NW
Canton, OH 44718-2531 - Phone
- (330) 492-8001
- Fax
- (330) 492-2080
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
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.
-
- Obstetrics & Gynecology Physician
- Alliance, OH
- NPI 1801267232
Obstetrics & Gynecology, OH
-
- Community/Retail Pharmacy
- Alliance, OH
- NPI 1205610466
-
- Community/Retail Pharmacy
- Canton, OH
- NPI 1700941978
-
- Multi-Specialty Clinic/Center
- Massillon, OH
- NPI 1386665149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040318001660 | OH | Practitioner - Obstetrics/Gynecology | 1951291236 | Reassigns benefits to 4 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35039711 | OH | MD | Specialist |
| 35-039711 | OH | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cleveland Clinic Mercy Hospital | Current | Accepting new patients | |
| Alliance Family Health Center, Inc | Current | Accepting new patients | |
| Aultman Hospital | Specialist | Current | Accepting new patients |
| Aultman Hospital | Current | Accepting new patients | |
| Alliance Family Health Center, Inc | Obstetrics & Gynecology | Current | Accepting new patients |
| DHSC LLC | Past | Accepting new patients |
Locations
1401 S Arch Ave
Alliance, OH 44601
Phone (330) 821-0201
1401 S Arch Ave
Ste A
Alliance, OH 44601
Phone (330) 249-7011
2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180
2600 7th St SW
Canton, OH 44710
Phone (330) 363-6242
1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000
1320 Mercy Dr NW
Spc Ser
Canton, OH 44708
Phone (330) 492-8720
Interoperability endpoints
- david.brandau.1@16473.direct.athenahealth.com
- https://api.platform.athenahealth.com/16473/brand/1/csg/1/fhir/r4
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 35039711 | OH | |
| Obstetrics & Gynecology Physician | 207V00000X | 35-039711 | OH | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
4151 Holiday St NW
Canton, OH 44718-2531
Mailing address
4151 Holiday St NW
Canton, OH 44718-2531
Phone (330) 492-8001
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| O426391 | Medicaid | OH |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 1, 2012.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1154317840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4151 HOLIDAY ST NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182531",
"telephone_number": "330-492-8001",
"fax_number": "330-492-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4151 HOLIDAY ST NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182531",
"telephone_number": "330-492-8001",
"fax_number": "330-492-2080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDAU",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "35039711",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OH",
"license": "35-039711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "O426391",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.