Individual provider Active NPI

Thomas J Brannigan, MD

  • Diagnostic Radiology Physician
  • La Mesa, CA
National Provider Identifier
1598710030
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G65789 Issued in CA
Practice address
8881 Fletcher Parkway
#102
La Mesa, CA 91942
Phone
(619) 461-1830
Fax
(619) 797-1484
NPI assigned
May 23, 2006
Last updated
Feb 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G65789 CA Primary

Addresses

Primary practice location

8881 Fletcher Parkway
#102
La Mesa, CA 91942

Mailing address

7777 Alvarado Rd
#108
La Mesa, CA 91942
Phone (619) 460-2770

Other identifiers 2

IdentifierTypeStateIssuer
00G657890OtherCABLUE SHIELD PIN
00G657890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050504000324 CA Practitioner - Diagnostic Radiology 6800857426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Irvine, California College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
X-Ray Medical Group IncGroup PAC ID 5294796801, 44 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 740-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Medical Group Inc Diagnostic Radiology CurrentSince Apr 20, 2005 Accepting new patients
Grossmont Hospital Corporation PastSince Apr 20, 2005 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

5565 Grossmont Center Dr
Ste 1
La Mesa, CA 91942
Phone (619) 463-4486

7777 Alvarado Rd
Ste 108
La Mesa, CA 91942
Phone 6194602770 ext. 303

8860 Center Dr
Ste 100
La Mesa, CA 91942
Phone (619) 740-4000

8881 Fletcher Pkwy
Ste 102
La Mesa, CA 91942
Phone (619) 461-1830

2527 Cranberry Hwy
Wareham, MA 02571
Phone (508) 295-5556

10 Little Brook Rd
West Wareham, MA 02576

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

Hospital & facility affiliations 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1598710030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 ALVARADO RD",
            "address_2": "#108",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-460-2770",
            "fax_number": "619-460-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8881 FLETCHER PARKWAY",
            "address_2": "#102",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-461-1830",
            "fax_number": "619-797-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNIGAN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G65789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "00G657890",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G657890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.