Brandon Tibbitts, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003752 Issued in CT

Practice address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337

Phone

(860) 777-1280

Fax

(860) 777-1276

NPI assigned

Jul 2, 2013

Last updated

Oct 10, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CT, MA3 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, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Demos Dermatology LLCGroup PAC ID 5890169882, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.78 of 100Reported as group

Quality

85.61

Promoting interoperability

100

Improvement activities

40

Cost

46.45

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: brandon.tibbitts@3466.securemail.prognocis.com
• Direct secure messaging: brandon.tibbitts@xdr.hhchealthdirect.org

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.

• Hartford Healthcare Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Avon, CT
  • NPI 1093239683
  Medicare reassignment Care Compare group
• Demos Dermatology, LLC

  • Dermatology Physician
  • West Springfield, MA
  • NPI 1730804634
  Medicare reassignment Care Compare group
• Integrated Dermatology of Enfield, LLC

  • Dermatology Physician
  • Simsbury, CT
  • NPI 1134544661
  Medicare reassignment
• College St Orthopedics

  dba Hamilton Orthopedic Surgery & Sports Medicine

  • Orthopaedic Surgery Physician
  • Hamilton, NY
  • NPI 1356300545
  Medicare reassignment

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1205276474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 ELM ST STE 304",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823739",
            "telephone_number": "860-741-2225",
            "fax_number": "860-741-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-777-1280",
            "fax_number": "860-777-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBITTS",
        "first_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003752",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "003752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Leona Corp (Altman Orthotics & Prosthetics)
• Jeffrey E. Thomsen, D.M.D.
• Katherine Thomsen, APRN
• Thomsen, Macarthur & Sehl, D.M.D.,PC
• Three Little Birds Counseling
• Alison Tingley
• Victor Tirado, MD
• Jared Tobias, LPC
• Gino Tordonato Jr., RPH
• Trimble Home Care LLC

• Physician Assistant in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.