Active NPI
Brandon Alan Madia, D.O.
- Psychiatry Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS12634
- Practice address
- 12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655 - Phone
- (239) 343-9180
- Fax
- (239) 343-9188
- NPI assigned
- Jun 17, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OS12634 | FL | Primary |
Addresses
Primary practice location
12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180
Other practice location 1
350 7th St N
Naples, FL 34102-5754
Phone (239) 624-1660
Other practice location 2
15901 Bass Rd Ste 108
Fort Myers, FL 33908-3838
Phone (239) 343-6050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022718400 | Medicaid | FL | |
| NR7MT | Other | FL | BCBS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bmadia252282@Direct.leememorial.org | Lee Memorial Health System |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900
12550 New Brittany Blvd
Suite 100
Fort Myers, FL 33907-3655
Phone (239) 343-9180
3501 Health Ctr Blvd
Estero, FL 34135-8128
Hospital & facility affiliations
- Lee Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS12634 | FL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Health System Inc | Current | Accepting new patients | |
| David Lawrence Mental Health Center, Inc | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700
15901 Bass Rd
Ste 108
Fort Myers, FL 33908
Phone (239) 343-9890
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
12550 New Brittany Blvd
Ste 100
Fort Myers, FL 33907
Phone (239) 343-9180
12550 New Brittany Blvd
Fort Myers, FL 33907
Phone (239) 343-9180
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
6075 Bathey Ln
Naples, FL 34116
Phone (239) 455-8500
Networks
- Freedom Health HMO Network
Interoperability endpoints
- bmadia252282@direct.leememorial.org
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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
- Community/Behavioral Health Agency
- Naples, FL
- NPI 1801891940
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1427806025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1487093183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12550 NEW BRITTANY BLVD STE 100",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073655",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
}
],
"practiceLocations": [
{
"address_1": "350 7th St N",
"address_purpose": "LOCATION",
"city": "Naples",
"state": "FL",
"postal_code": "341025754",
"country_code": "US",
"telephone_number": "239-624-1660",
"fax_number": "239-624-1661",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15901 Bass Rd Ste 108",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339083838",
"country_code": "US",
"telephone_number": "239-343-6050",
"fax_number": "239-343-6051",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MADIA",
"first_name": "BRANDON",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-17",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "OS12634",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022718400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "NR7MT",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bmadia252282@Direct.leememorial.org",
"affiliation": "Y",
"affiliationName": "Lee Memorial Health System",
"address_1": "2776 Cleveland Ave",
"city": "Fort Myers",
"state": "FL",
"country_code": "US",
"postal_code": "339015864",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.