NPIMap

Individual provider Active NPI

Robert T. Brebrick, M.D.

  • Surgery Physician
  • Wausau, WI
National Provider Identifier
1619979465
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39500-020 Issued in WI
Practice address
2606 Stewart Ave FL 2
Wausau, WI 54401-5449
Phone
(715) 847-2022
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39500-020 WI Primary

Addresses

Primary practice location

2606 Stewart Ave FL 2
Wausau, WI 54401-5449

Mailing address

2606 Stewart Ave FL 2
Wausau, WI 54401-5449
Phone (715) 847-2022

Other practice location 1

2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022

Other identifiers 1

IdentifierTypeStateIssuer
32485100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050209000217 WI Practitioner - General Surgery 5294786034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates, S.C.Group PAC ID 3072400019, 26 clinicians

Practice addresses (Care Compare)

2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.56 of 100Reported as group
Quality
90.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39500-020WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates, S.C. Surgery CurrentSince Jul 18, 2006 Accepting new patients
Aspirus Specialist Inc. Past Accepting new patients

Locations

2606 Stewart Ave
Fl 2
Wausau, WI 54401
Phone (715) 847-2022

2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022

Interoperability endpoints

  • Direct secure messaging: rbrebrick14764@direct.aspirus.org

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1619979465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 STEWART AVE FL 2",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015449",
            "telephone_number": "715-847-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 STEWART AVE FL 2",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015449",
            "telephone_number": "715-847-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Pine Ridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544017803",
            "country_code": "US",
            "telephone_number": "715-847-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREBRICK",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "39500-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32485100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.