Individual provider Active NPI

Suja M Brane, MD

  • Family Medicine Physician
  • Mason, OH
National Provider Identifier
1306802616
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
355084078 Issued in OH
Practice address
9313 S Mason Montgomery Rd
Ste. 250
Mason, OH 45040-8081
Phone
(513) 584-6898
Fax
(513) 584-6897
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 355084078 OH Primary
Family Medicine Physician 207Q00000X 39149 KY

Addresses

Primary practice location

9313 S Mason Montgomery Rd
Ste. 250
Mason, OH 45040-8081

Mailing address

9313 Mason-Montgomery Rd.
Ste. 250
Mason, OH 45040
Phone (513) 584-6898

Other identifiers 2

IdentifierTypeStateIssuer
64092430MedicaidKY
2505177MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39149KYMDFamily Medicine Physician
355084078OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. Family Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1306802616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9313 MASON-MONTGOMERY RD.",
            "address_2": "STE. 250",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-584-6898",
            "fax_number": "513-584-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9313 S MASON MONTGOMERY RD",
            "address_2": "STE. 250",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408081",
            "telephone_number": "513-584-6898",
            "fax_number": "513-584-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANE",
        "first_name": "SUJA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "355084078",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "39149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64092430",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2505177",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.