Individual provider Active NPI

Todd D Brandon, M.D.

  • Surgery Physician
  • Angola, IN
National Provider Identifier
1174594766
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
01053917A Issued in IN
Practice address
306 E Maumee St Ste 102
Angola, IN 46703-2044
Phone
(260) 668-8633
Fax
(260) 668-7563
NPI assigned
Jan 31, 2006
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01053917A IN Primary

Addresses

Primary practice location

306 E Maumee St Ste 102
Angola, IN 46703-2044

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20070228000125 IN Practitioner - General Surgery 0446251334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

306 E Maumee St
Suite 102
Angola, IN 46703-2044
Phone (260) 668-8633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Memorial Community Hospital, Inc. CurrentSince Oct 3, 2024 Accepting new patients
Cameron Memorial Community Hospital, Inc Surgery CurrentSince Oct 3, 2024 Accepting new patients
Parkview Health System Inc Surgery CurrentSince Jul 1, 2013 Accepting new patients
Cameron Memorial Community Hospital Inc Past Accepting new patients
Indiana Surgical Specialists, LLC Surgery Past Accepting new patients
Associated Surgeons and Physicians, LLC Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

150 Growth Pkwy
Angola, IN 46703
Phone (260) 665-1670

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

306 E Maumee St
Ste 102
Angola, IN 46703
Phone (260) 266-5300

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

11141 Parkview Plaza Dr
Ste 305
Fort Wayne, IN 46845
Phone (260) 266-8900

3898 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 425-5750

3898 New Vision Dr
Ste E
Fort Wayne, IN 46845
Phone (260) 471-8141

2003 Stults Rd
#120
Huntington, IN 46750
Phone (260) 454-0425

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

Interoperability endpoints

  • Direct secure messaging: tbrandon4496@direct.parkviewexchange.com

Organizations & group practices 6

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1174594766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST STE 102",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032044",
            "telephone_number": "260-668-8633",
            "fax_number": "260-668-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "TODD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01053917A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.