Individual provider Active NPI

Brian R Webster, P.A.

  • Physician Assistant
  • Port Charlotte, FL
National Provider Identifier
1164580536
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1237 Issued in CO
Practice address
530 Tamiami Trail
Port Charlotte, FL 33953
Phone
(941) 391-5296
Fax
(941) 391-5297
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1237 CO Primary

Addresses

Primary practice location

530 Tamiami Trail
Port Charlotte, FL 33953

Mailing address

12101 Highway 61
Sterling, CO 80751-8428
Phone (970) 521-8858

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141103000373 FL Practitioner - Physician Assistant 3779704952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Medical Solutions LLCGroup PAC ID 9335430107, 2 clinicians

Practice addresses (Care Compare)

1260 NE 8TH St
Suite 110
Cape Coral, FL 33909-3169
Phone (239) 443-4716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Medica Camaguey Primary Care LLC PastSince Apr 27, 2025 Accepting new patients
Cape Coral Injury Clinic LLC Physician Assistant PastSince Nov 3, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164580536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 HIGHWAY 61",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807518428",
            "telephone_number": "970-521-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 TAMIAMI TRAIL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33953",
            "telephone_number": "941-391-5296",
            "fax_number": "941-391-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "BRIAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.