Individual provider Active NPI

Brandon W Brasher, P.A.

  • Medical Physician Assistant
  • Prineville, OR
National Provider Identifier
1629284641
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA152971 Issued in OR
Practice address
384 SE Combs Flat Rd
Prineville, OR 97754-2562
Phone
(541) 447-8750
Fax
(541) 447-8428
NPI assigned
May 15, 2007
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2899 AZ
Medical Physician Assistant 363AM0700X PA152971 OR Primary

Addresses

Primary practice location

384 SE Combs Flat Rd
Prineville, OR 97754-2562

Mailing address

1207 NE Hudspeth Circle
Prineville, OR 97754
Phone (928) 234-2068

Other practice location 1

1103 NE Elm Street
Suite P
Prineville, OR 97754
Phone (541) 447-6263

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbrasher18172@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110111000946 OR Practitioner - Physician Assistant 7618166307 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2899AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Sep 1, 2018 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jul 1, 2010 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 1, 2026 Accepting new patients
St. Charles Health System, Inc. CurrentSince Sep 1, 2018 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 1, 2026 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jul 1, 2010 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2042 NE Williamson Ct
Ste 100
Bend, OR 97701
Phone (541) 526-6603

2200 NE Neff Rd
Ste 200
Bend, OR 97701
Phone (541) 322-2331

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920

470 NE A St
Madras, OR 97741
Phone (541) 475-3882

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

384 SE Combs Flat Rd
Ste 1200
Prineville, OR 97754
Phone (541) 447-6263

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

1315 NW 4th St
Redmond, OR 97756
Phone (541) 388-2333

1523 NW Canal Blvd
Redmond, OR 97756
Phone (541) 383-3668

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Interoperability endpoints

  • Direct secure messaging: bbrasher18172@secure.stcharleshealthcare.org

Organizations & group practices 6

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 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1629284641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NE HUDSPETH CIRCLE",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "97754",
            "telephone_number": "928-234-2068",
            "fax_number": "541-416-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 SE COMBS FLAT RD",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977542562",
            "telephone_number": "541-447-8750",
            "fax_number": "541-447-8428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1103 NE Elm Street",
            "address_2": "Suite P",
            "address_purpose": "LOCATION",
            "city": "Prineville",
            "state": "OR",
            "postal_code": "97754",
            "country_code": "US",
            "telephone_number": "541-447-6263",
            "fax_number": "541-416-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASHER",
        "first_name": "BRANDON",
        "middle_name": "W",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2899",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA152971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbrasher18172@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "384 SE Combs Flat Rd",
            "city": "Prineville",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977542562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prineville, OR

Sources for this page

Verify at the official NPI Registry.