Justin R Bryant, DO, MBA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

OS21663 Issued in FL

Practice address

11141 Parkview Plaza Dr Ste 300
Fort Wayne, IN 46845-1715

Phone

(260) 425-6960

NPI assigned

Aug 13, 2010

Last updated

May 22, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WI, FL2 enrollments

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 2

Specialty

Plastic and Reconstructive Surgery

Education

Oklahoma State University College of Osteopathic Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Business Administration

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: jbryant455257@direct.parkviewexchange.com
• Direct secure messaging: justin.bryant.1@9147.direct.athenahealth.com
• Direct secure messaging: justin.bryant@fpg.directbygreenway.com

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.

• SMH Physician Services Inc

  dba First Physicians Group

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• SMH Physician Services Inc

  dba First Physicians Group

  • Gynecology Physician
  • Sarasota, FL
  • NPI 1275525826
  NPD (past)

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

• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1427363449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 PARKVIEW PLAZA DR STE 300",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451715",
            "telephone_number": "260-425-6960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1921 Waldemere St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392941",
            "country_code": "US",
            "telephone_number": "941-262-4001",
            "fax_number": "941-262-4028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "71983",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "DO034726",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IN",
            "license": "02004908A",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "OS21663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427363449",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbryant455257@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 300",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 300",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11141 Parkview Plaza Dr Ste 300",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Lynne Bryan, O.D.
• Emily Nicole Bryan, M.A., CCC-SLP
• Julie Bryan, M.D.
• Cressilee Bryant, M.D.
• Javonuna Bryant
• Leslie Bryant, DDS
• Olivia Bryant, FNP
• Robert Lee Bryant, BA, MS, PHD
• Bogna Natalia Brzezinska, MD
• Haitam Mohamad Buaisha, MD

• Plastic and Reconstructive Surgery Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Plastic and Reconstructive Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.

Verify at the official NPI Registry.