Individual provider Active NPI

Brandon Carter McDuffie, PA-C

  • Physician Assistant
  • Manchester, NH
National Provider Identifier
1225289168
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1918 Issued in NH
Practice address
87 McGregor St Ste 2100
Manchester, NH 03102-3767
Phone
(603) 626-7546
Fax
(603) 626-7548
NPI assigned
Oct 9, 2008
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1918 NH Primary

Addresses

Primary practice location

87 McGregor St Ste 2100
Manchester, NH 03102-3767

Mailing address

526 Main St Ste 302
Acton, MA 01720-3301
Phone (978) 371-7010

Other practice location 1

2 Pillsbury St Ste 501
Concord, NH 03301-3576
Phone (603) 333-2908

Other identifiers 1

IdentifierTypeStateIssuer
016128300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221207001169 NH Practitioner - Physician Assistant 0547394314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adult and Pediatric Dermatology PCGroup PAC ID 7012988306, 38 clinicians

Practice addresses (Care Compare)

2 Pillsbury St
Suite 501
Concord, NH 03301-3576
Phone (603) 333-2908

87 McGregor St
Suite 2100
Manchester, NH 03102-3767
Phone (603) 626-7546

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1918NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Derm New Hampshire PC Past Accepting new patients
Leavitt Medical Associates of Florida Inc PastSince Sep 1, 2019 Accepting new patients
Skin Care Physicians Past Accepting new patients

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.

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": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1225289168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MAIN ST STE 302",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203301",
            "telephone_number": "978-371-7010",
            "fax_number": "978-371-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MCGREGOR ST STE 2100",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023767",
            "telephone_number": "603-626-7546",
            "fax_number": "603-626-7548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Pillsbury St Ste 501",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033013576",
            "country_code": "US",
            "telephone_number": "603-333-2908",
            "fax_number": "603-715-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDUFFIE",
        "first_name": "BRANDON",
        "middle_name": "CARTER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-09",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016128300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.