Michael Lucas Brasel, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA00197 Issued in MS

Practice address

1777 Ellis Ave
Jackson, MS 39204-3616

Phone

(601) 371-0400

NPI assigned

Jan 30, 2014

Last updated

Jan 30, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Copiah County Medical Center

  • Critical Access Hospital
  • Hazlehurst, MS
  • NPI 1588667281
  Medicare reassignment
• Copiah County Medical Center

  dba Crystal Springs Clinic

  • Rural Health Clinic/Center
  • Crystal Springs, MS
  • NPI 1972603819
  NPD
• First Intermed Corporation

  dba MEA Medical Clinics

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1346275310
  NPD
• Hardy Wilson Memorial Hospital

  • Critical Access Hospital
  • Hazlehurst, MS
  • NPI 1477876274
  NPD (past)

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1184047904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4092 HIGHWAY 472",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390839650",
            "telephone_number": "601-894-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 ELLIS AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043616",
            "telephone_number": "601-371-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASEL",
        "first_name": "MICHAEL",
        "middle_name": "LUCAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MS",
            "license": "PA00197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Wallace Brantley Jr., DMD
• Kara L Brantley, M.D.
• Leigh Allyson Brantley, CRNA
• Terry Keith Brantley, MD
• Himmat Singh Brar, MD
• Hannah Elizabeth Bratcher, PA-C
• Dustin R Bratton, MD
• Latoya Braylock
• Breakthrough Family Services
• Larry C Breeding, D.M.D.

• Medical Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Medical Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.

Verify at the official NPI Registry.