Julie Ellen Brandenburg, MSW
Individual provider Active NPI Social Worker · Pendleton, OR
NPI 1306149802 · NPPES record last updated Aug 3, 2022
Key facts
- NPI
- 1306149802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- L10782 (OR)
- Practice address
- 46314 Timine Way
Pendleton, OR 97801 - Phone
- (541) 966-9830
- Fax
- (541) 240-8751
- NPI assigned
- Dec 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yellowhawk Tribal Health Center
Practice addresses (Care Compare)
46314 Timine Way
Pendleton, OR 97801-9417
Phone (541) 966-9830
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210409000346 | TX | Practitioner - Clinical Social Worker | 6305254426 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L10782 | OR | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yellowhawk Tribal Health Center | Current |
Accepting new patients |
Locations
46314 Timine Way
Pendleton, OR 97801
Phone (541) 966-9830
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | L10782 | OR | Yes |
Addresses
Primary practice location
46314 Timine Way
Pendleton, OR 97801
Mailing address
46314 Timine Way
Pendleton, OR 97801
Phone (541) 966-9830
Other providers in Pendleton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.