Benjamin Scott Brandvig

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1386198 Issued in TX

Practice address

12413 Judson Rd Ste 100
Live Oak, TX 78233-3262

Phone

(210) 314-1071

NPI assigned

Dec 13, 2023

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Medicine Associates of San Antonio PAGroup PAC ID 3274525548, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sports Medicine Associates of San Antonio, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Antonio, TX
  • NPI 1861549503

  Physical Therapist, TX

  Medicare reassignment Care Compare group NPD
• Texas Physical Therapy Specialists, Inc.

  • Physical Therapist
  • New Braunfels, TX
  • NPI 1689781338
  Medicare reassignment NPD
• Sports Medicine Associates of San Antonio, PA

  • Orthopaedic Surgery Physician
  • San Antonio, TX
  • NPI 1568280808
  NPD
• Texas Physical Therapy Specialists

  • Durable Medical Equipment & Medical Supplies
  • Austin, TX
  • NPI 1568049484
  NPD
• Sports Medicine Associates of San Antonio, PA

  • Physical Therapist
  • San Antonio, TX
  • NPI 1609124312
  NPD (past)

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1376311985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "726-202-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12413 JUDSON RD STE 100",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333262",
            "telephone_number": "210-314-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDVIG",
        "first_name": "BENJAMIN",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1386198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Bowden
• Caitlin Bowlin, LP
• Anthony Austin A Boyd, RBT,CNA,PCT,ESTI,RDA
• Monet Braddy
• Alexcis Jacqueline Bradley, LCSW-S
• Eric Michael Braseth, MD
• Brian E Schulze MD PA
• Chardaya Briggs
• Gordon Briscoe, D.N.P
• Michael Brogdon

• All providers in Live Oak, TX
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.