Marie Elyse Brewer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

099904 Issued in IA

Practice address

3385 Dexter CT Ste 101
Davenport, IA 52807-3471

Phone

(563) 359-1646

NPI assigned

Feb 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT Professional Services PCGroup PAC ID 8426949298, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mbrewer@entprofessional.gwaydirect.com

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.

• ENT Professional Services, PC

  • Specialist
  • Davenport, IA
  • NPI 1457499758

  IL

  Medicare reassignment Care Compare group
• ENT Hearing AIDS, LLC

  • Audiologist
  • Davenport, IA
  • NPI 1316189715
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1609409184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT STE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-359-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT STE 101",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-359-1646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 John Deere Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612656812",
            "country_code": "US",
            "telephone_number": "563-359-1646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "MARIE",
        "middle_name": "ELYSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "099904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breakthrough Wellness
• Elise Bream, M.D.
• Matthew J. Bream, MD
• Breathe Easy Health Care
• Lynn M Breneman-Wisong, DDS
• Roberta Brewer, LISW
• Johnny Edward Brian Jr., MD
• Bridge-Davenport, LP
• Bridgecare ABA Ia LLC
• Thomas Briegel, LMT

• Physician Assistant in Davenport, IA
• Providers in Davenport, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; 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.
• 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.