Individual provider Active NPI

Gary Robert Brownell, PA-C

  • Physician Assistant
  • Ocoee, FL
National Provider Identifier
1619945979
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103311 Issued in FL
Practice address
10000 W Colonial Dr
Ocoee, FL 34761-3498
Phone
(407) 296-1000
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103311 FL Primary

Addresses

Primary practice location

10000 W Colonial Dr
Ocoee, FL 34761-3498

Mailing address

PO Box 361907
Melbourne, FL 32936-1907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080403000164 FL Practitioner - Physician Assistant 1153408943 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JM Holdings of Brevard IncGroup PAC ID 1254637978, 8 clinicians
Dairy Road Urgent Care LLCGroup PAC ID 9133269293, 7 clinicians

Practice addresses (Care Compare)

1698 W Hibiscus Blvd
Suite B
Melbourne, FL 32901-2639
Phone (321) 676-3200

2107 Dairy Rd
Melbourne, FL 32904-5241
Phone (321) 956-8224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9103311FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Orange Healthcare Inc Past Accepting new patients
Brevard Emergency Services Past Accepting new patients
Space Coast Health Care Services Past Accepting new patients
St Lucie Medical Center Walk-in Clinic LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: gary.brownell.1@32269.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1619945979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361907",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613498",
            "telephone_number": "407-296-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWNELL",
        "first_name": "GARY",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.