Brandon Tyler Worley, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME143350 Issued in FL

Practice address

421 Linden LN
Lake Wales, FL 33853-4342

Phone

(855) 353-7546

Fax

(863) 676-1015

NPI assigned

Dec 26, 2018

Last updated

Aug 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

K Wade Foster MD PAGroup PAC ID 3173663374, 17 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• K Wade Foster MD PA

  dba Florida Dermatology & Skin Cancer Centers

  • MOHS-Micrographic Surgery Physician
  • Winter Haven, FL
  • NPI 1205066404

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Gregorio Medalle PA

  dba Gregorio N. Medalle, M.D., P.a.

  • Surgery Physician
  • Wauchula, FL
  • NPI 1194039321

  Single Specialty

  NPD (past)
• Virginia Ann Schekorra PA

  • Dermatology Physician
  • Pinellas Park, FL
  • NPI 1003004862

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1457823809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 LINDEN LN",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534342",
            "telephone_number": "312-695-7932",
            "fax_number": "312-695-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 LINDEN LN",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534342",
            "telephone_number": "855-353-7546",
            "fax_number": "863-676-1015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Medical Way",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "33870",
            "country_code": "US",
            "telephone_number": "863-658-3870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1052 Downing Cir",
            "address_purpose": "LOCATION",
            "city": "Wauchula",
            "state": "FL",
            "postal_code": "338733358",
            "country_code": "US",
            "telephone_number": "863-767-0625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3725 S Hwy 27 Ste 105",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347117600",
            "country_code": "US",
            "telephone_number": "352-717-0644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORLEY",
        "first_name": "BRANDON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2022-08-03",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME143350",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.148375",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME143350",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME143350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chester C Wilmot, M.D.
• Audranay Shavone Wilson
• Tatyana Wimbley
• Winn -Dixie Pharmacy
• Richard L. Witcher, RPH
• Zarzuela LLC (Love 2 Ride Transport)

• MOHS-Micrographic Surgery Physician in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.