NPIMap

Individual provider Active NPI

Miguel B Brillantes, MD

  • Internal Medicine Physician
  • Fall River, MA
National Provider Identifier
1609878859
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
154081 Issued in MA
Practice address
1565 North Main Street
Suite 306
Fall River, MA 02720-2972
Phone
(508) 973-9500
Fax
(508) 973-0351
NPI assigned
Jun 1, 2005
Last updated
Apr 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 154081 MA Primary

Addresses

Primary practice location

1565 North Main Street
Suite 306
Fall River, MA 02720-2972

Mailing address

200 Mill Road
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Other identifiers 1

IdentifierTypeStateIssuer
110059156AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbrillantes5581@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041129000351 MA Practitioner - Internal Medicine 1557326824 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians
Premier Healthcare Services LLCGroup PAC ID 9931442381, 12 clinicians

Practice addresses (Care Compare)

1565 N Main St
Suite 306
Fall River, MA 02720-2972
Phone (508) 973-9500

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

7 Schooner CT
New Bedford, MA 02745-1033
Phone (774) 644-9320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154081MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare Services, LLC CurrentSince Sep 25, 2023 Accepting new patients
Southcoast Hospitals Group, Inc CurrentSince Sep 10, 1997 Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Sep 10, 1997 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Catholic Memorial Home Past Accepting new patients
Premier Healthcare Services, LLC Internal Medicine PastSince Sep 25, 2023 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

1565 N Main St
Fall River, MA 02720
Phone (508) 324-0328

1565 N Main St
Ste 306
Fall River, MA 02720
Phone (508) 675-0369

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

829 Main Rd
Westport, MA 02790
Phone (508) 636-3731

Interoperability endpoints

  • Direct secure messaging: mbrillantes5581@direct.southcoast.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fall River Jewish HomeFall River, MA, CCN 225317 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 5, 2025
Feb 5, 2025
Southcoast Visiting Nurse Association, IncFairhaven, MA, CCN 227101 Home health agency Corporate Director Apr 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 7

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1609878859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL ROAD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 NORTH MAIN STREET",
            "address_2": "SUITE 306",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027202972",
            "telephone_number": "508-973-9500",
            "fax_number": "508-973-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRILLANTES",
        "first_name": "MIGUEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "154081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110059156A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrillantes5581@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "1565 North Main Street",
            "address_2": "Suite 306",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027202972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.