Individual provider Active NPI

Brendan Thomas Tribble, MD

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1528043346
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2013-01939 Issued in NC
Practice address
131 Providence Rd Dept of
Charlotte, NC 28207-1206
Phone
(704) 749-5800
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2013-01939 NC Primary

Addresses

Primary practice location

131 Providence Rd Dept of
Charlotte, NC 28207-1206

Mailing address

1028 22ND St
San Diego, CA 92102-1906
Phone (360) 293-9392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140102000295 NC Practitioner - AnesthesiologyPractitioner - Pain Management 6709014434 Reassigns benefits to 1 organization
I20210409000123 SC Practitioner - Anesthesiology 6709014434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Northwestern University Feinberg Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

1800 E 4TH St
Charlotte, NC 28204-3210
Phone (704) 384-1300

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-01939NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince May 1, 2017 Accepting new patients

Locations

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

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 6

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1528043346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 22ND ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021906",
            "telephone_number": "360-293-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 PROVIDENCE RD DEPT OF",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071206",
            "telephone_number": "704-749-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIBBLE",
        "first_name": "BRENDAN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2013-01939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.