Individual provider Active NPI

Brandon Michael Wubben, MD

  • Emergency Medicine Physician
  • O Fallon, MO
National Provider Identifier
1205327111
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2025029102 Issued in MO
Practice address
2 Progress Point Pkwy
Dept Emergency Med
O Fallon, MO 63368-2205
Phone
(314) 362-9123
Fax
(314) 747-9160
NPI assigned
May 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2025029102 MO Primary

Addresses

Primary practice location

2 Progress Point Pkwy
Dept Emergency Med
O Fallon, MO 63368-2205

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-9123

Other identifiers 1

IdentifierTypeStateIssuer
200118016MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210513001252 AZ Practitioner - Emergency Medicine 3971912452 Reassigns benefits to 1 organization
I20250827002026 MO Practitioner - Emergency Medicine 3971912452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington University Community Specialists LLCGroup PAC ID 8628588514, 94 clinicians

Practice addresses (Care Compare)

2 Progress Point Pkwy
O Fallon, MO 63368-2205
Phone (314) 362-9123

Hospital & facility affiliations

  • Progress West Hospital Hospital, Ofallon, MO, CCN 260219

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Arizona, Inc. Emergency Medicine CurrentSince Mar 8, 2022 Accepting new patients
Washington University Community Specialists, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

1225 Graham Rd
#U
Florissant, MO 63031

2 Progress Point Pkwy
#U
O Fallon, MO 63368

2 Progress Point Pkwy
O Fallon, MO 63368
Phone (636) 344-1000

660 S Euclid Ave
Saint Louis, MO 63110

10 Hospital Dr
#U
Saint Peters, MO 63376

Interoperability endpoints

  • Direct secure messaging: bwubben80449@uihcdirect.org

Organizations & group practices 2

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.

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": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1205327111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PROGRESS POINT PKWY",
            "address_2": "DEPT EMERGENCY MED",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682205",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUBBEN",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2025-09-09",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2025029102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200118016",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "2 Progress Point Pkwy",
            "address_2": "Dept Emergency Med",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633682205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.