NPIMap

Individual provider Active NPI

Douglas W Brandt, MD

  • Diagnostic Radiology Physician
  • Kingman, AZ
National Provider Identifier
1184821092
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
49933 Issued in MN
Practice address
3269 Stockton Hill Rd
Kingman, AZ 86409-3619
Phone
(928) 757-0620
NPI assigned
Jul 3, 2007
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 49933 MN Primary

Addresses

Primary practice location

3269 Stockton Hill Rd
Kingman, AZ 86409-3619

Mailing address

3269 Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 757-0620

Other identifiers 1

IdentifierTypeStateIssuer
073195000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000091 AZ Practitioner - Diagnostic Radiology 2062507577 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians
Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 263-4722

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49933MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Sep 15, 2022 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Sep 17, 2010 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Aug 25, 2025 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Aug 25, 2025 Accepting new patients
Yuma Regional Medical Center CurrentSince Sep 15, 2022 Accepting new patients
Kingman Healthcare, Inc CurrentSince Sep 17, 2010 Accepting new patients
Mayo Clinic Past Accepting new patients
Kingman Healthcare, Inc Family Medicine Past Accepting new patients

Locations

1033 Sycamore Ave
Kingman, AZ 86409
Phone (928) 681-8600

1608 N Stockton Hill Rd
Ste 104
Kingman, AZ 86401
Phone (928) 718-0180

2002 N Stockton Hill Rd
Ste 103
Kingman, AZ 86401
Phone (602) 526-0848

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1720 Mesquite Ave
Ste 202
Lk Havasu Cty, AZ 86403
Phone (928) 854-5358

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Interoperability endpoints

  • Direct secure messaging: brandt.douglas@direct.azkrmc.md

Organizations & group practices 8

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 2

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1184821092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "49933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073195000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.