Brandon W Brasher, P.A.
Individual provider Active NPI Medical Physician Assistant · Prineville, OR
NPI 1629284641 · NPPES record last updated Apr 24, 2020
Key facts
- NPI
- 1629284641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA152971 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Charles Health System Inc
Practice addresses (Care Compare)
211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164
Hospital & facility affiliations
- St Charles Medical Center Prineville
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110111000946 | OR | Practitioner - Physician Assistant | 7618166307 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2899 | AZ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Charles Health System, Inc. | Current |
Accepting new patients | |
| St. Charles Health System, Inc. | Current |
Accepting new patients | |
| St. Charles Health System, Inc. | Current |
Accepting new patients | |
| St. Charles Health System, Inc. | Current |
Accepting new patients | |
| St. Charles Health System, Inc. | Past | Accepting new patients | |
| St. Charles Health System, Inc. | Past | Accepting new patients |
Locations
29358 Network Pl
Chicago, IL 60673
2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333
2200 NE Neff Rd
Ste 200
Bend, OR 97701
Phone (541) 322-2331
2042 NE Williamson Ct
Ste 100
Bend, OR 97701
Phone (541) 526-6603
51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920
470 NE A St
Madras, OR 97741
Phone (541) 383-3668
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
211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164
1523 NW Canal Blvd
Redmond, OR 97756
Phone (541) 383-3668
Interoperability endpoints
- bbrasher18172@secure.stcharleshealthcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2899 | AZ | |
| Medical Physician Assistant | 363AM0700X | PA152971 | OR | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bbrasher18172@secure.stcharleshealthcare.org |
Other providers in Prineville, OR
- Dean Louis Bonanno
- Karen Kay Bones
- Leigh Bowerfind
- Tiffany Boyum
- Michelle C Brandsma
- Shannon K Brasher
- Kathryn Broadaway
- Mary Katherine Brook
- Jenna Danielle Brown
- Christopher Brubaker
All providers in Prineville, OR · Medical Physician Assistant in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.