Individual provider Active NPI

Brandon Jacob Stern, PT

  • Physical Medicine & Rehabilitation Physician
  • Gilbert, AZ
National Provider Identifier
1629585401
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
13542 Issued in AZ
Practice address
3011 S Lindsay Rd Ste 114
Gilbert, AZ 85295-4334
Phone
(480) 814-8222
Fax
(480) 814-8225
NPI assigned
Jan 3, 2018
Last updated
Jan 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 13542 AZ Primary

Addresses

Primary practice location

3011 S Lindsay Rd Ste 114
Gilbert, AZ 85295-4334

Mailing address

3011 S Lindsay Rd Ste 114
Gilbert, AZ 85295-4334
Phone (480) 814-8222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13542AZMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1629585401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 S LINDSAY RD STE 114",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954334",
            "telephone_number": "480-814-8222",
            "fax_number": "480-814-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 S LINDSAY RD STE 114",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954334",
            "telephone_number": "480-814-8222",
            "fax_number": "480-814-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "BRANDON",
        "middle_name": "JACOB",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "13542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.