Mario Ignacio Brakin, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

A-33396 Issued in CA

Practice address

2650 Elm Ave Ste 318
Long Beach, CA 90806-1600

Phone

(562) 595-0166

Fax

(562) 595-6714

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Mario I. Brakin, M.D., F.a.a.P., Inc

  dba pediatric Endocrinology Associates

  • Pediatric Endocrinology Physician
  • Long Beach, CA
  • NPI 1164442620
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1215921028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 ELM AVE STE 318",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061600",
            "telephone_number": "562-595-0166",
            "fax_number": "562-595-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 ELM AVE STE 318",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061600",
            "telephone_number": "562-595-0166",
            "fax_number": "562-595-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKIN",
        "first_name": "MARIO",
        "middle_name": "IGNACIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "A-33396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A333960",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond J Brady, D.D.S.
• Vivian Marybell Brady, PA-C
• Marina Braff
• Justine Marie Alicaya Braga, FNP
• Laurie V Brainerd, FNP-C
• Aurelia Brambila
• Sabrina Marie Brambila, LPT
• Desiree Marni Bramlett, MFT
• Deanna Bramont, RADT
• Jessica Bran

• Pediatric Endocrinology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatric Endocrinology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.