Brendan Alexander Williams, M.D.

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

MT215089 Issued in PA

Practice address

3401 Civic Center Blvd
Division of Pediatric Orthopaedics
Philadelphia, PA 19104

Phone

(215) 590-3131

NPI assigned

Apr 24, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

Orthopedic Surgery

Education

University of Missouri, Columbia School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Children'S Surgical Associates LTDGroup PAC ID 9739083494, 53 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children'S Surgical Associates LTD

  • Plastic Surgery Physician
  • Philadelphia, PA
  • NPI 1326117185
  Medicare reassignment Care Compare group NPD
• Children'S Surgical Associates LTD

  • Surgery Physician
  • Philadelphia, PA
  • NPI 1942379797
  NPD
• Children'S Surgical Associates LTD

  • Urology Physician
  • Philadelphia, PA
  • NPI 1003985854
  NPD (past)
• Children'S Surgical Associates LTD

  • Pediatric Surgery Physician
  • Philadelphia, PA
  • NPI 1760562581

  Orthopaedic Surgery

  NPD (past)
• Children'S Surgical Associates LTD

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1821177395
  NPD (past)

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1629336086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC ORTHOPAEDICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC ORTHOPAEDICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-3131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Hull Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326074144",
            "country_code": "US",
            "telephone_number": "352-273-7001",
            "fax_number": "352-273-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRENDAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME124635",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "PA",
            "license": "MT215089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021286800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "JA199Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlyn E Williams, FNP
• Austin David Williams, MD
• Barbara Lee Williams, B.S.
• Benson Williams
• Bianca R Williams
• Brennen Reece Williams
• Brianna Talia Williams
• Brighton Williams
• Brittany Michelle Williams
• Bruce Williams Sr., D.O.

• Pediatric Orthopaedic Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.