Individual provider Active NPI

Gary O'Rian Brown, M.D.

  • Family Medicine Physician
  • Hollywood, FL
National Provider Identifier
1467864660
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME129502 Issued in FL
Practice address
4105 Pembroke Rd
Hollywood, FL 33021-8103
Phone
(954) 276-5552
Fax
(954) 985-2295
NPI assigned
May 22, 2014
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN20219 FL
Family Medicine Physician 207Q00000X ME129502 FL Primary

Addresses

Primary practice location

4105 Pembroke Rd
Hollywood, FL 33021-8103

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
111330500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gbrown281577@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210910001899 FL Practitioner - Family Practice 4486879509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, shared by 55 NPIs, 659 clinicians

Practice addresses (Care Compare)

1951 SW 172ND Ave
Miramar, FL 33029-5613

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Sep 1, 2021 Accepting new patients
South Broward Hospital District CurrentSince Sep 1, 2021 Accepting new patients
South Broward Hospital District Family Medicine CurrentSince Oct 28, 2024 Accepting new patients
South Broward Hospital District CurrentSince Jun 1, 2023 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

16620 Sheridan St
Fort Lauderdale, FL 33331
Phone (954) 265-3451

8665 NW 186th St
Hialeah, FL 33015
Phone (305) 682-2626

4105 Pembroke Rd
Hollywood, FL 33021
Phone (954) 985-1551

1951 SW 172nd Ave
Ste 210
Miramar, FL 33029
Phone (954) 538-5699

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: gbrown281577@mhsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1467864660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 PEMBROKE RD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218103",
            "telephone_number": "954-276-5552",
            "fax_number": "954-985-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GARY",
        "middle_name": "O'RIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-22",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN20219",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME129502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111330500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbrown281577@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "4105 Pembroke Rd",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330218103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.