Individual provider Active NPI

Brandon Hensley

  • Surgical Physician Assistant
  • Clearwater, FL
National Provider Identifier
1205373727
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9110139 Issued in FL
Practice address
430 Morton Plant St Ste 301
Clearwater, FL 33756
Phone
(727) 461-6026
Fax
(727) 796-4345
NPI assigned
Jan 22, 2017
Last updated
Jul 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9110139 FL Primary

Addresses

Primary practice location

430 Morton Plant St Ste 301
Clearwater, FL 33756

Mailing address

430 Morton Plant St Ste 301
Clearwater, FL 33756-3395
Phone (727) 461-6026

Other practice location 1

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Other identifiers 2

IdentifierTypeStateIssuer
NH9QMOtherFLBCBS
019927400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9110139FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Oct 16, 2021 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Oct 16, 2021 Accepting new patients

Locations

430 Morton Plant St
Ste 301
Clearwater, FL 33756

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

5504 Gateway Blvd
Wesley Chapel, FL 33544
Phone (813) 948-5400

16521 US 301 S
Wimauma, FL 33598
Phone (813) 844-4700

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1485043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1205373727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MORTON PLANT ST STE 301",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563395",
            "telephone_number": "727-461-6026",
            "fax_number": "727-796-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MORTON PLANT ST STE 301",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "727-461-6026",
            "fax_number": "727-796-4345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13020 N Telecom Pkwy",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336370925",
            "country_code": "US",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-22",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9110139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NH9QM",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019927400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.