NPIMap

Individual provider Active NPI

Gregory Alan Brandenberg, MD, PH.D.

  • Neurological Surgery Physician
  • Ames, IA
National Provider Identifier
1487629762
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
38061 Issued in IA
Practice address
1015 Duff Ave
McFarland Clinic, PC
Ames, IA 50010-3014
Phone
(515) 239-4468
Fax
(515) 663-8683
NPI assigned
Feb 21, 2006
Last updated
Jul 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 35-08-5970-B OH
Neurological Surgery Physician 207T00000X 38061 IA Primary

Addresses

Primary practice location

1015 Duff Ave
McFarland Clinic, PC
Ames, IA 50010-3014

Mailing address

PO Box 3014
1015 Duff Ave McFarland Clinic, PC
Ames, IA 50010-3014
Phone (515) 239-4468

Other identifiers 1

IdentifierTypeStateIssuer
1487629762MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124002030 SD Practitioner - Neurosurgery 0143269456 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
38061IAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Dec 3, 2017 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Dec 3, 2017 Accepting new patients
Gregory a Brandenberg MD, PHD, Inc Neurological Surgery PastSince Apr 1, 2005 Accepting new patients
Mid Missouri Neurosurgery, LLP Neurological Surgery Past Accepting new patients
Boone Physician Services, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Neurosurgery Inc Neurological Surgery Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Interoperability endpoints

  • Direct secure messaging: gregory.brandenberg@avera.sdhealthlink.net

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1487629762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3014",
            "address_2": "1015 DUFF AVE MCFARLAND CLINIC, PC",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500103014",
            "telephone_number": "515-239-4468",
            "fax_number": "515-663-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DUFF AVE",
            "address_2": "MCFARLAND CLINIC, PC",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500103014",
            "telephone_number": "515-239-4468",
            "fax_number": "515-663-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBERG",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "credential": "MD, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35-08-5970-B",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IA",
            "license": "38061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487629762",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.