NPIMap

Individual provider Active NPI

Brandon Michael Custer, M.D.

  • Diagnostic Radiology Physician
  • Gainesville, FL
National Provider Identifier
1255607859
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
04-38716 Issued in KS
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-2741
Phone
(352) 265-0438
NPI assigned
Mar 28, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 04-38716 KS Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-2741

Mailing address

PO Box 100374
Gainesville, FL 32610-3841
Phone (352) 265-0438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710002233 KS Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5395973457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 1, 2018 Accepting new patients
Kansas University Physicians Inc Diagnostic Radiology Current Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-3974

Interoperability endpoints

  • Direct secure messaging: bcuster23727@direct.kuha.org

Organizations & group practices 3

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 3

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1255607859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100374",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103841",
            "telephone_number": "352-265-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326102741",
            "telephone_number": "352-265-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-38716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.