Active NPI
Thomas Brenzel, MD
- Internal Medicine Physician
- Charleston, SC
National Provider Identifier
1548825409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- LL86307
- Practice address
- 169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905 - Phone
- (843) 792-0435
- NPI assigned
- May 7, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL86307 | SC | |
| Internal Medicine Physician | 207R00000X | LL86307 | SC | Primary |
Addresses
Primary practice location
169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905
Mailing address
169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905
Phone (843) 792-0435
Other practice location 1
500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210827002688 | SC | Order and Referring Only - Internal Medicine | 6406251404 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1548825409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "843-792-0435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258905",
"telephone_number": "843-792-0435"
}
],
"practiceLocations": [
{
"address_1": "500 S Preston St Rm 305",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402021702",
"country_code": "US",
"telephone_number": "502-852-8696",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRENZEL",
"first_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-07",
"last_updated": "2021-06-16",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL86307",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "LL86307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.