Individual provider Active NPI

Brett Alan Faulknier, D.O.

  • Clinical Cardiac Electrophysiology Physician
  • Vero Beach, FL
National Provider Identifier
1346380771
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
OS13906 Issued in FL
Practice address
3450 11TH CT Ste 104a
Vero Beach, FL 32960-5012
Phone
(772) 226-4830
Fax
(772) 226-4835
NPI assigned
Feb 7, 2007
Last updated
Apr 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 1868 WV
Clinical Cardiac Electrophysiology Physician 207RC0001X L8684 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X OS13906 FL Primary

Addresses

Primary practice location

3450 11TH CT Ste 104a
Vero Beach, FL 32960-5012

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Other identifiers 2

IdentifierTypeStateIssuer
018849900MedicaidFL
2003756000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20161028001439 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 1951456029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
West Virginia School of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians

Practice addresses (Care Compare)

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

1190 37TH St
Vero Beach, FL 32960-6507
Phone (772) 567-4311

3450 11TH CT
Vero Beach, FL 32960-5012

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1868WVMDProfessional Counselor
L8684TXMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Aug 1, 2016 Accepting new patients
Indian River Health Services Inc CurrentSince Aug 1, 2016 Accepting new patients
Indian River Health Services Inc Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4444

3450 11th Ct
Ste 104A
Vero Beach, FL 32960
Phone (772) 226-4830

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1346380771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311",
            "fax_number": "772-794-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 11TH CT STE 104A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605012",
            "telephone_number": "772-226-4830",
            "fax_number": "772-226-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNIER",
        "first_name": "BRETT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WV",
            "license": "1868",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "L8684",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "OS13906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018849900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003756000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.