NPIMap

Individual provider Active NPI

Justin R. Brazeal, MD

  • Orthopaedic Surgery Physician
  • College Station, TX
National Provider Identifier
1437339249
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
N6826 Issued in TX
Practice address
2803 Earl Rudder Fwy S
Suite 103
College Station, TX 77845-6099
Phone
(979) 731-8888
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X N6826 TX Primary

Addresses

Primary practice location

2803 Earl Rudder Fwy S
Suite 103
College Station, TX 77845-6099

Mailing address

2803 Earl Rudder Fwy S
Suite 103
College Station, TX 77845-6099
Phone (979) 731-8888

Other identifiers 2

IdentifierTypeStateIssuer
307869301MedicaidTX
282074801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000294 TX Practitioner - Orthopedic Surgery 1153599675 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Orthopaedic Surgery CurrentSince Aug 1, 2013 Accepting new patients
St Joseph Regional Health Center CurrentSince Aug 1, 2013 Accepting new patients
College Station Hospital LP Past Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients

Locations

2800 S Texas Ave
Ste 202
Bryan, TX 77802
Phone (979) 774-2060

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

2803 Earl Rudder Fwy S
Ste 103
College Station, TX 77845
Phone (979) 731-8888

Interoperability endpoints

  • Direct secure messaging: justin.brazeal@sjrhc.eclinicaldirectplus.com
  • Direct secure messaging: jbrazeal455983@direct.stlukeshealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health Center 141 clinicians

Practice addresses (Care Compare)

2803 Earl Rudder Fwy S
Suite 103
College Station, TX 77845-6099
Phone (979) 731-8888

Hospital & facility affiliations

  • Elara Caring Home health agency, Round Rock, TX, CCN 457661
  • CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011
  • Burleson St Joseph Health Center Hospital, Caldwell, TX, CCN 451305
  • Grimes St Joseph Health Center Hospital, Navasota, TX, CCN 451322

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement14
Knee replacement25
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1437339249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 EARL RUDDER FWY S",
            "address_2": "SUITE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456099",
            "telephone_number": "979-731-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 EARL RUDDER FWY S",
            "address_2": "SUITE 103",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456099",
            "telephone_number": "979-731-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEAL",
        "first_name": "JUSTIN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "N6826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307869301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282074801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.