Individual provider Active NPI

Benjamin William Brewer, PA-C

  • Physician Assistant
  • N Charleston, SC
National Provider Identifier
1235997784
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5249 Issued in SC
Practice address
3815 Faber Place Dr
N Charleston, SC 29405-8533
Phone
(843) 767-9312
Fax
(843) 767-9313
NPI assigned
Mar 11, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 5249 SC Primary

Addresses

Primary practice location

3815 Faber Place Dr
N Charleston, SC 29405-8533

Mailing address

3815 Faber Place Dr
N Charleston, SC 29405-8533
Phone (843) 767-9312

Other identifiers 1

IdentifierTypeStateIssuer
6948PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240826004088 SC Practitioner - Physician Assistant 2668911371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Nephrology Associates, LLCGroup PAC ID 9638138209, 18 clinicians

Practice addresses (Care Compare)

3815 Faber Place Dr
North Charleston, SC 29405-8533
Phone (843) 767-9260

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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 5

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": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1235997784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "BENJAMIN",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6948PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Charleston, SC

Sources for this page

Verify at the official NPI Registry.