Alexander Brazalovich, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1364 Issued in ME

Practice address

813 Main St
Massabesic Regional Medical Center
Waterboro, ME 04087-3006

Phone

(207) 247-6131

Fax

(207) 247-6675

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in ME, TX2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

65.17 of 100Reported as group

Quality

47.69

Improvement activities

40

Cost

79.8

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mainehealth

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819
  Medicare reassignment NPD
• DHHS IHS Phoenix Area

  • Clinic/Center
  • Peach Springs, AZ
  • NPI 1265719934

  TX

  Medicare reassignment NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• Mainehealth

  • Skilled Nursing Facility
  • Sanford, ME
  • NPI 1447342209
  NPD
• DHHS IHS Phoenix

  • Clinic/Center
  • Supai, AZ
  • NPI 1184901829
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teecnospos, AZ
  • NPI 1477615789
  NPD
• University of New England

  • Family Medicine Physician
  • Biddeford, ME
  • NPI 1699752055
  NPD (past)
• York County Community Action Corp

  • Federally Qualified Health Center (FQHC)
  • Springvale, ME
  • NPI 1497923916
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295787133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DOUGLAS AVE",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040729732",
            "telephone_number": "207-283-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 MAIN ST",
            "address_2": "MASSABESIC REGIONAL MEDICAL CENTER",
            "city": "WATERBORO",
            "state": "ME",
            "postal_code": "040873006",
            "telephone_number": "207-247-6131",
            "fax_number": "207-247-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZALOVICH",
        "first_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1364",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7659431002",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "MN3424",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS START NUMBER",
            "identifier": "037872",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285210099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blaney LCPC, LLC
• Susan C Caron
• Emily Carrick, OTR/L
• Scott Thomas Castonguay, PHARMACIST
• Kaitlin Murphy Champagne, OTR/L
• Melissa Cunningham, LMT

• Family Medicine Physician in Waterboro, ME
• Providers in Waterboro, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.