Individual provider Active NPI

Carl William Brango, MD

  • Family Medicine Physician
  • Brogue, PA
National Provider Identifier
1497773162
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD054551L Issued in PA
Practice address
10 Muddy Creek Forks Rd
Suite 3
Brogue, PA 17309-9497
Phone
(717) 812-5020
Fax
(717) 461-7144
NPI assigned
Jul 18, 2006
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD054551L PA Primary

Addresses

Primary practice location

10 Muddy Creek Forks Rd
Suite 3
Brogue, PA 17309-9497

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 812-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040719001503 PA Practitioner - Family Practice 2062491335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

10 Muddy Creek Forks Rd
Suite 3
Brogue, PA 17309-9497
Phone (717) 812-5020

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD054551LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince May 14, 2004 Accepting new patients
Wellspan Medical Group Family Medicine CurrentSince May 14, 2004 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10 Muddy Creek Forks Rd
Ste 3
Brogue, PA 17309
Phone (717) 812-5020

13515 Wolfe Rd
Ste C
New Freedom, PA 17349
Phone (717) 812-2501

1001 S George St
York, PA 17403
Phone (717) 812-7687

1600 S George St
York, PA 17403
Phone (717) 848-3615

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

300 Pine Grove Cmns
York, PA 17403
Phone (717) 812-4390

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: cbrango13719@wellspan.direct-ci.com

Organizations & group practices 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1497773162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-812-5020",
            "fax_number": "717-461-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MUDDY CREEK FORKS RD",
            "address_2": "SUITE 3",
            "city": "BROGUE",
            "state": "PA",
            "postal_code": "173099497",
            "telephone_number": "717-812-5020",
            "fax_number": "717-461-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANGO",
        "first_name": "CARL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD054551L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brogue, PA

Sources for this page

Verify at the official NPI Registry.