Individual provider Active NPI

Brian Thomas Vernau, MD

  • Pediatric Sports Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1457593220
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
MD448618 Issued in PA
Practice address
34TH St and Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4399
Phone
(215) 590-1527
Fax
(215) 590-1501
NPI assigned
Mar 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X MD448618 PA Primary

Addresses

Primary practice location

34TH St and Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4399

Mailing address

100 E Penn SQ
The Wanamaker BLDG. 9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150313000477 PA Practitioner - Sports Medicine 2668798406 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD448618PAMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Associates LTD Current Accepting new patients
Children'S Surgical Associates LTD CurrentSince Oct 3, 2022 Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients
Children'S Surgical Associates LTD Sports Medicine Past Accepting new patients

Locations

100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538

3401 Civic Center Blvd
Ste 34
Philadelphia, PA 19104

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1457593220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "THE WANAMAKER BLDG. 9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9538",
            "fax_number": "267-425-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH ST AND CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-1527",
            "fax_number": "215-590-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNAU",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "PA",
            "license": "MD448618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.