Individual provider Active NPI

David R Brandau, M.D.

  • Obstetrics & Gynecology Physician
  • Canton, OH
National Provider Identifier
1154317840
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35-039711 Issued in OH
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.

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
35039711OHMDSpecialist
35-039711OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Mercy Hospital CurrentSince Aug 4, 2015 Accepting new patients
Alliance Family Health Center, Inc CurrentSince Oct 1, 2016 Accepting new patients
Aultman Hospital Specialist CurrentSince May 1, 1991 Accepting new patients
Aultman Hospital CurrentSince May 1, 1991 Accepting new patients
Alliance Family Health Center, Inc Obstetrics & Gynecology CurrentSince Oct 1, 2016 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

  • Direct secure messaging: david.brandau.1@16473.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16473/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35039711 OH
Obstetrics & Gynecology Physician 207V00000X 35-039711 OH Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
O426391MedicaidOH

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

Verify at the official NPI Registry.