Individual provider Active NPI

Brent Austin Tucker, PA-C

  • Surgical Physician Assistant
  • Olney, MD
National Provider Identifier
1396297248
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C06263 Issued in MD
Practice address
3414 Olandwood CT
Olney, MD 20832-1384
Phone
(301) 774-0500
Fax
(301) 774-7338
NPI assigned
Oct 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C06263 MD
Medical Physician Assistant 363AM0700X C06263 MD
Surgical Physician Assistant 363AS0400X C06263 MD Primary

Addresses

Primary practice location

3414 Olandwood CT
Olney, MD 20832-1384

Mailing address

3414 Olandwood CT
Olney, MD 20832-1384
Phone (301) 774-0500

Other practice location 1

10710 Charter Dr Ste 300
Columbia, MD 21044-3260
Phone (410) 644-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170206000142 MD Practitioner - Physician Assistant 1355624933 Reassigns benefits to 2 organizations
I20170206000203 DC Practitioner - Physician Assistant 1355624933 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians
Johns Hopkins UniversityGroup PAC ID 4981745098, 711 clinicians

Practice addresses (Care Compare)

10710 Charter Dr
Suite 300
Columbia, MD 21044-3260
Phone (410) 644-1880

19801 Observation Dr
Germantown, MD 20876-4070
Phone (301) 694-8311

19851 Observation Dr
Suite 450
Germantown, MD 20876-4070
Phone (301) 977-6777

3414 Olandwood CT
Olney, MD 20832-1384
Phone (301) 774-0500

5255 Loughboro Rd NW
Washington, DC 20016-2633
Phone (202) 660-6500

Hospital & facility affiliations

  • Medstar Montgomery Medical Center Hospital, Olney, MD, CCN 210018
  • Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048
  • Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065
  • Suburban Hospital Hospital, Bethesda, MD, CCN 210022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C06263MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince Aug 5, 2019 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 12, 2016 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Aug 5, 2019 Accepting new patients
Johns Hopkins University CurrentSince Sep 1, 2021 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 12, 2016 Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Aug 5, 2019 Accepting new patients
Johns Hopkins University CurrentSince Sep 1, 2021 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Dec 12, 2016 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

10700 Charter Dr
Ste 100
Columbia, MD 21044
Phone (301) 774-0500

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

19851 Observation Dr
Ste 450
Germantown, MD 20876
Phone (301) 977-3605

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

Interoperability endpoints

  • Direct secure messaging: btucker368851@direct.hopkinsmedicine.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1396297248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321384",
            "telephone_number": "301-774-0500",
            "fax_number": "301-774-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 OLANDWOOD CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321384",
            "telephone_number": "301-774-0500",
            "fax_number": "301-774-7338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10710 Charter Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210443260",
            "country_code": "US",
            "telephone_number": "410-644-1880",
            "fax_number": "410-730-1617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BRENT",
        "middle_name": "AUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-26",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06263",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C06263",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C06263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.