Individual provider Active NPI

Brandon D Liebelt, MD

  • Neurological Surgery Physician
  • San Antonio, TX
National Provider Identifier
1477872398
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
V7560 Issued in TX
Practice address
4502 Medical Dr FL 2
San Antonio, TX 78229-4402
Phone
(210) 358-8555
Fax
(210) 358-8576
NPI assigned
May 18, 2010
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 042.0014122 VT
Neurological Surgery Physician 207T00000X V7560 TX Primary
Neurological Surgery Physician 207T00000X 53493 AZ

Addresses

Primary practice location

4502 Medical Dr FL 2
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr FL 2
San Antonio, TX 78229-4402
Phone (210) 358-8555

Other identifiers 1

IdentifierTypeStateIssuer
252516MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20180814001927 VT Practitioner - Neurosurgery 4082982954 Reassigns benefits to 1 organization
I20250926002049 TX Practitioner - Neurosurgery 4082982954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53493AZMDNeurological Surgery Physician
042.0014122VTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Aug 10, 2017 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Aug 1, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Aug 1, 2025 Accepting new patients
District Medical Group, Inc CurrentSince Aug 10, 2017 Accepting new patients
University of Vermont Medical Center Inc Neurological Surgery CurrentSince Jul 20, 2018 Accepting new patients
University of Texas Health Science Center at San Antonio Neurological Surgery CurrentSince Sep 14, 2025 Accepting new patients
University of Texas Health Science Center at San Antonio PastSince Sep 14, 2025 Accepting new patients
University of Vermont Medical Center Inc Past Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

4502 Medical Dr
Fl 2
San Antonio, TX 78229
Phone (210) 358-8144

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Interoperability endpoints

  • Direct secure messaging: bleibelt134058@direct.valleywisehealth.org
  • Direct secure messaging: bliebelt66542@direct.utmsa.com

Organizations & group practices 9

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 5

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1477872398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-8555",
            "fax_number": "210-358-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-8555",
            "fax_number": "210-358-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBELT",
        "first_name": "BRANDON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VT",
            "license": "042.0014122",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "V7560",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "53493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252516",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.