Individual provider Active NPI

Brandon K Pendegraft, DPT

  • Physical Therapist
  • Huntsville, AL
National Provider Identifier
1588103444
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH8318 Issued in AL
Practice address
1140 Eagletree Lane SE
Huntsville, AL 35801
Phone
(256) 883-0636
Fax
(256) 883-0635
NPI assigned
Feb 13, 2017
Last updated
Apr 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH8318 AL Primary

Addresses

Primary practice location

1140 Eagletree Lane SE
Huntsville, AL 35801

Mailing address

1140 Eagletree Lane SE
Huntsville, AL 35801
Phone (256) 883-0636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621002178 AL Practitioner - Physical Therapist in Private Practice 2860760543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus Physiotherapy, LLCGroup PAC ID 4284940339, 22 clinicians

Practice addresses (Care Compare)

1140 Eagletree LN SE
Huntsville, AL 35801-7428
Phone (256) 883-0636

Merit-based Incentive Payment System (MIPS)

Final score
72.3 of 100Reported as group
Quality
48.65
Improvement activities
40
Cost
76.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH8318ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Physiotherapy, LLC CurrentSince Apr 15, 2019 Accepting new patients

Locations

2246 Winchester Rd NE
Ste 101
Huntsville, AL 35811
Phone (256) 261-3044

4031 Balmoral Dr SW
#B
Huntsville, AL 35801
Phone (256) 883-0636

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1588103444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 EAGLETREE LANE SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-883-0636",
            "fax_number": "256-883-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 EAGLETREE LANE SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-883-0636",
            "fax_number": "256-883-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDEGRAFT",
        "first_name": "BRANDON",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.