Branden Lee Mossman, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.007003 Issued in IL

Practice address

2650 Ridge Ave # 4210
Evanston, IL 60201

Phone

(847) 570-1010

NPI assigned

Feb 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV, IL, IN3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians of Indiana LLCGroup PAC ID 4981841780, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: toboyle@northshore.org

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.

• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Gary, IN
  • NPI 1528311149
  Medicare reassignment Care Compare group
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment
• Hospitalist Medicine Physicians of Indiana, LLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1720416555

  IN

  Medicare reassignment
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Sound Physicians of Indiana, LLC

  • Hospitalist Physician
  • Terre Haute, IN
  • NPI 1184063257
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Methodist Hospitals, Inc

  • General Acute Care Hospital
  • Gary, IN
  • NPI 1467504555
  Care Compare affiliation

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1194184911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE B70",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE # 4210",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2610 W Horizon Ridge Pkwy",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890522869",
            "country_code": "US",
            "telephone_number": "702-724-8777",
            "fax_number": "702-724-8749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2610 W Horizon Ridge Pkwy",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890522869",
            "country_code": "US",
            "telephone_number": "702-724-8777",
            "fax_number": "702-724-8749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSSMAN",
        "first_name": "BRANDEN",
        "middle_name": "LEE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-22",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007003",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TOBoyle@northshore.org",
            "affiliation": "N",
            "endpointDescription": "Office of professional Staff",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9977 Woods Dr Ste B70",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600771057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Margie S. Morrison, M.S.W., LCSW
• Helene Moses, LCSW
• Kenneth Moses, PHD
• Fernando F Mosqueda, O.D.
• Jax Anthony Mosquera
• Katherine Mott, MD
• Jeanette Marie Vollert Moulthrop, M.D.
• Mark A Moulthrop, PH.D.
• Mariam R Mourad, PH.D.
• Move to Help Foundation

• Physician Assistant in Evanston, IL
• Providers in Evanston, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.