Individual provider Active NPI

Paul Robert Brown, PA C

  • Medical Physician Assistant
  • Toledo, OH
National Provider Identifier
1508040312
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085000868 Issued in IL
Practice address
2222 Cherry St
Mob 2 - Ste 1250 C/O Mercy Cardiothoracic Surgical
Toledo, OH 43608-2673
Phone
(419) 251-3180
Fax
(419) 251-3849
NPI assigned
Dec 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085000868 IL Primary
Surgical Physician Assistant 363AS0400X 50001371 OH

Addresses

Primary practice location

2222 Cherry St
Mob 2 - Ste 1250 C/O Mercy Cardiothoracic Surgical
Toledo, OH 43608-2673

Mailing address

449 Mockingbird CT
Lindenhurst, IL 60046-4933
Phone (847) 316-6844

Other identifiers 1

IdentifierTypeStateIssuer
50-001371OtherOHMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120717000315 OH Practitioner - Physician Assistant 1355507526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Christ Hospital Cardiovascular Associates LLCGroup PAC ID 1658449715, 151 clinicians

Practice addresses (Care Compare)

2123 Auburn Ave
Cincinnati, OH 45219-2906

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 585-2000

Hospital & facility affiliations

  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085000868ILMDMedical Physician Assistant
50001371OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Hospital Cardiology Assoc Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1508040312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 MOCKINGBIRD CT",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600464933",
            "telephone_number": "847-316-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 CHERRY ST",
            "address_2": "MOB 2 - STE 1250 C/O MERCY CARDIOTHORACIC SURGICAL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082673",
            "telephone_number": "419-251-3180",
            "fax_number": "419-251-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PAUL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085000868",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50001371",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "50-001371",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.