Individual provider Active NPI

Steven E Brandenburg, PA

  • Physician Assistant
  • Middletown, OH
National Provider Identifier
1346294238
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
500000699 Issued in OH
Practice address
105 McKnight Dr
Middletown, OH 45044-4838
Phone
(513) 424-2111
NPI assigned
May 22, 2006
Last updated
Aug 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 500000699 OH Primary

Addresses

Primary practice location

105 McKnight Dr
Middletown, OH 45044-4838

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164

Other practice location 1

752 N Main St
Springboro, OH 45066-8944
Phone (937) 208-6865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040410000161 OH Practitioner - Physician Assistant 1456345768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
500000699OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Family Medicine PastSince Oct 13, 2021 Accepting new patients
Fairfield Hospitalists Inc Past Accepting new patients
Uvpc Specialists Inc. Past Accepting new patients
Middletown Emergency Physicians, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sbrandenburg450750@direct.bsmhealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1346294238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MCKNIGHT DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450444838",
            "telephone_number": "513-424-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "752 N Main St",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450668944",
            "country_code": "US",
            "telephone_number": "937-208-6865",
            "fax_number": "937-208-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "STEVEN",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "500000699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.