NPIMap

Individual provider Active NPI

Brandon Arthur Luedtke, PA

  • Physician Assistant
  • Saginaw, MI
National Provider Identifier
1518475730
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008544 Issued in MI
Practice address
3085 Hallmark CT Ste 1
Saginaw, MI 48603-6803
Phone
(989) 996-0566
Fax
(989) 401-2876
NPI assigned
Jan 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4400 TN
Physician Assistant 363A00000X 5601008544 MI Primary

Addresses

Primary practice location

3085 Hallmark CT Ste 1
Saginaw, MI 48603-6803

Mailing address

3085 Hallmark CT Ste 1
Saginaw, MI 48603-6803
Phone (989) 996-0566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180220002162 MI Practitioner - Physician Assistant 4183985880 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Country Community Mental HealthGroup PAC ID 8820052095, 18 clinicians
Bay-Arenac Behavioral HealthGroup PAC ID 5496706228, 30 clinicians
Saginaw County Community Mental Health AuthorityGroup PAC ID 7719037332, 25 clinicians
List Psychological Services, PLCGroup PAC ID 6709799323, 28 clinicians

Practice addresses (Care Compare)

1420 Plaza Dr
Petoskey, MI 49770-9420
Phone (231) 347-7890

201 Mulholland St
Bay City, MI 48708-7693

500 Hancock St
Saginaw, MI 48602-4224
Phone (989) 797-3400

5024 N Ctr Rd
Saginaw, MI 48604-9412
Phone (989) 790-3130

624 W Nepessing St
Suite 300
Lapeer, MI 48446-2089
Phone (810) 667-4500

6250 M 66
Charlevoix, MI 49720-9272
Phone (231) 547-5885

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
41.32 of 100Reported as group
Quality
20
Improvement activities
0
Cost
84.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4400TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
List Psychological Services, PLC Psychiatry CurrentSince Feb 28, 2018 Accepting new patients
List Psychological Services, PLC Psychiatry CurrentSince Feb 28, 2018 Accepting new patients
Alternative Community Living, Inc. PastSince Sep 24, 2023 Accepting new patients
North Country Community Mental Health Past Accepting new patients

Locations

110 E Huron Ave
Bad Axe, MI 48413
Phone (989) 269-7666

126 Washington Ave
Bay City, MI 48708
Phone (989) 684-7977

443 N State St
Caro, MI 48723
Phone (989) 672-6160

651 N State St
Caro, MI 48723
Phone (989) 672-6160

467 N State St
Caro, MI 48723
Phone (989) 672-6160

350 N Court St
Ste 205
Lapeer, MI 48446
Phone (810) 667-4500

624 W Nepessing St
Ste 300
Lapeer, MI 48446
Phone (810) 667-4500

5024 N Center Rd
Saginaw, MI 48604
Phone (989) 672-6160

33 W Sanilac Rd
Sandusky, MI 48471
Phone (810) 648-0668

Interoperability endpoints

  • Direct secure messaging: listpsychologicalservicesplc.brandonluedtke@130916.advancedmd-direct.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 and National Provider Directory roles.

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": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1518475730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 HALLMARK CT STE 1",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486036803",
            "telephone_number": "989-996-0566",
            "fax_number": "989-401-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 HALLMARK CT STE 1",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486036803",
            "telephone_number": "989-996-0566",
            "fax_number": "989-401-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDTKE",
        "first_name": "BRANDON",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.