Individual provider Active NPI

Brandon Schornack, DO

  • Allergy & Immunology Physician
  • Bethesda, MD
National Provider Identifier
1225497738
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
1720 Issued in NE
Practice address
8901 Wisconsin Ave
Allergy/Immunology Clinic, Building 19
Bethesda, MD 20814
Phone
(301) 295-4000
NPI assigned
Feb 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1720 NE
Allergy & Immunology Physician 207K00000X 1720 NE Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Allergy/Immunology Clinic, Building 19
Bethesda, MD 20814

Mailing address

8901 Wisconsin Ave
Allergy/Immunology Clinic, Building 19
Bethesda, MD 20814
Phone (301) 295-4000

Other practice location 1

9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-1330

Other practice location 2

1585 3rd St
Fort Polk, LA 71459-5102
Phone (337) 531-3942

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherTRICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20220330000952 NE Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8426444597

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1720NEMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1225497738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "ALLERGY/IMMUNOLOGY CLINIC, BUILDING 19",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20814",
            "telephone_number": "301-295-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "ALLERGY/IMMUNOLOGY CLINIC, BUILDING 19",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20814",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9040 Fitzsimmons Dr",
            "address_purpose": "LOCATION",
            "city": "Joint Base Lewis McChord",
            "state": "WA",
            "postal_code": "984311000",
            "country_code": "US",
            "telephone_number": "253-968-1330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1585 3rd St",
            "address_purpose": "LOCATION",
            "city": "Fort Polk",
            "state": "LA",
            "postal_code": "714595102",
            "country_code": "US",
            "telephone_number": "337-531-3942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHORNACK",
        "first_name": "BRANDON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-12",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "1720",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NE",
            "license": "1720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "1585 3rd St",
            "city": "Fort Polk",
            "state": "LA",
            "country_code": "US",
            "postal_code": "714595102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.