Active NPI
Brandon Bentley, MD
- Sports Medicine (Family Medicine) Physician
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 95418
- Practice address
- 1120 15TH St
Augusta, GA 30912-5857 - Phone
- (706) 721-8623
- Fax
- (706) 721-1459
- NPI assigned
- Jun 10, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME147385 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 95418 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-5857
Mailing address
1120 15TH St # Or6000
Augusta, GA 30912-0004
Phone (706) 721-3813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108673700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623
1220 W Wheeler Pkwy
Augusta, GA 30909-6625
Phone (706) 721-8623
1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810
229 S Belair Rd
Martinez, GA 30907-8834
Phone (706) 760-7607
4244 Washington Rd
Evans, GA 30809-3087
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171
Hospital & facility affiliations
- Wellstar MCG Health, Affiliated With Med Col
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME147385 | FL | MD | Family Medicine Physician |
| 95418 | GA | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Family Medicine | Current | Accepting new patients |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients |
Locations
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785
1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813
1220 W Wheeler Pkwy
Augusta, GA 30909
Phone (706) 721-2741
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Physical Therapist
- Augusta, GA
- NPI 1679286934
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Surgery Physician
- Austell, GA
- NPI 1316230329
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1437135902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1407415797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST # OR6000",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309125857",
"telephone_number": "706-721-8623",
"fax_number": "706-721-1459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "BRANDON",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-10",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME147385",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "GA",
"license": "95418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108673700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.