Individual provider Active NPI

Brandon Edward Kuebler, MD

  • Pediatric Cardiology Physician
  • Jacksonville, FL
National Provider Identifier
1538376496
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME109642 Issued in FL
Practice address
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Phone
(904) 202-8550
Fax
(904) 393-7808
NPI assigned
May 17, 2007
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101243850 VA
Pediatric Cardiology Physician 2080P0202X 65697 GA
Pediatric Cardiology Physician 2080P0202X ME109642 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350

Mailing address

PO Box 746645
Atlanta, GA 30374-6645
Phone (904) 202-2092

Other practice location 1

601 N Clyde Morris Blvd Ste A
Daytona Beach, FL 32114-2300
Phone (904) 202-8550

Other identifiers 1

IdentifierTypeStateIssuer
1538376496MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 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
I20110728000193 FL Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Adult Congenital Heart Disease (Achd) 4688711435 Reassigns benefits to 2 organizations
I20210420000002 GA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Adult Congenital Heart Disease (Achd) 4688711435

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Adult Congenital Heart Disease (Achd), Cardiovascular Disease (Cardiology)
Education
West Virginia University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nemours FoundationGroup PAC ID 9537072483, 249 clinicians

Practice addresses (Care Compare)

8331 N Davis Hwy
Childrens Spec Care
Pensacola, FL 32514-6094
Phone (850) 505-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101243850VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Aug 11, 2024 Accepting new patients
The Nemours Foundation CurrentSince Sep 22, 2025 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Sep 1, 2021 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Sep 22, 2025 Accepting new patients
R Steven White M D P a PastSince Mar 6, 2010 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology PastSince May 25, 2021 Accepting new patients

Locations

1219 Dunn Ave
Daytona Beach, FL 32114
Phone (386) 255-4568

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

836 Prudential Dr
Ste 802
Jacksonville, FL 32207
Phone (904) 202-8290

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

Interoperability endpoints

  • Direct secure messaging: bkuebler42185@direct.nemours.org
  • Direct secure messaging: bkuebler66189@direct.shands.ufl.edu

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.

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1538376496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746645",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746645",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 280",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078350",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Clyde Morris Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142300",
            "country_code": "US",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUEBLER",
        "first_name": "BRANDON",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101243850",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "65697",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME109642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538376496",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.