Individual provider Active NPI

Jeffrey S Brindle, MD

  • Radiation Oncology Physician
  • Watertown, SD
National Provider Identifier
1619906120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
1610 Issued in SD
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7000
Fax
(605) 882-7636
NPI assigned
Jun 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 1610 SD Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Other identifiers 1

IdentifierTypeStateIssuer
5604232MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050507000068 SD Practitioner - Radiation Oncology 2567457559 Reassigns benefits to 1 organization
I20221220000724 MN Practitioner - Radiation Oncology 2567457559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5552NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Range Regional Health Services CurrentSince Dec 15, 2022 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Jan 1, 2005 Accepting new patients
Range Regional Health Services Current Accepting new patients
Range Regional Health Services CurrentSince Dec 15, 2022 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Jan 1, 2005 Accepting new patients
Prairie Lakes Health Care System Inc Past Accepting new patients
Diagnostic Radiology Associates LLC Past Accepting new patients

Locations

1814 14th Ave E
Hibbing, MN 55746
Phone (218) 262-3441

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Interoperability endpoints

  • Direct secure messaging: jbrindle754561@fairview.direct-ci.com

Organizations & group practices 7

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 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619906120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINDLE",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SD",
            "license": "1610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5604232",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.