Kirsten N Brondstater, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9107257 Issued in FL

Practice address

1605 W Fairbanks Ave
Winter Park, FL 32789-4603

Phone

(407) 975-0200

Fax

(407) 975-0209

NPI assigned

May 16, 2007

Last updated

Sep 20, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1275749053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894603",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894603",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONDSTATER",
        "first_name": "KIRSTEN",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002279",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9107257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00657230",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eduarda Brito-Pascual, NP
• Daniel Brito, NP,APRN
• Rando Brito, BACHELOR OF ARTS
• Genesis Brletic
• Courtney Bromfield
• Catherine L Bronza, LCSW
• Pam F Brooks, LCSW
• Jasmine S Broomfield
• Karen Langfur Broussard, LCSW
• Delaney Brown, CCC-SLP

• Medical Physician Assistant in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.