Individual provider Active NPI

Brian Ballard Wexler

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1558780601
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT205981 Issued in PA
Practice address
3400 Spruce St
Hosp of Upenn, Dept of Emerg. Med., Ground Floor Ravdin
Philadelphia, PA 19104-4238
Phone
(215) 662-6305
Fax
(215) 662-2875
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT205981 PA Primary

Addresses

Primary practice location

3400 Spruce St
Hosp of Upenn, Dept of Emerg. Med., Ground Floor Ravdin
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Hosp of Upenn, Dept of Emerg. Med., Ground Floor Ravdin
Philadelphia, PA 19104-4238
Phone (215) 662-6305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180907001203 MD Practitioner - Emergency Medicine 4284930728 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT205981PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Washington Emergency Physicians, Inc. Emergency Medicine CurrentSince Jul 17, 2018 Accepting new patients

Locations

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1558780601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "HOSP OF UPENN, DEPT OF EMERG. MED., GROUND FLOOR RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-6305",
            "fax_number": "215-662-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "HOSP OF UPENN, DEPT OF EMERG. MED., GROUND FLOOR RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-6305",
            "fax_number": "215-662-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEXLER",
        "first_name": "BRIAN",
        "middle_name": "BALLARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT205981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.