Individual provider Active NPI

Brett Gordon Menmuir, M.D.

  • Orthopaedic Surgery Physician
  • Orlando, FL
National Provider Identifier
1639150204
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME134260 Issued in FL
Practice address
1724 33Rd St Ste 200
Orlando, FL 32839
Phone
(407) 385-1551
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X ME134260 FL
Orthopaedic Surgery Physician 207X00000X ME134260 FL Primary

Addresses

Primary practice location

1724 33Rd St Ste 200
Orlando, FL 32839

Mailing address

11603 Sheldon Rd
Tampa, FL 33626-4306
Phone (775) 786-3040

Other practice location 1

555 N Arlington Ave
Reno, NV 89503-4723
Phone (775) 786-3040

Other identifiers 4

IdentifierTypeStateIssuer
100505993MedicaidFL
H87507OtherFLMEDICARE UPIN
39576OtherFLMEDICARE UPIN
9947OtherFLBXBS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20171204000022 FL Practitioner - Orthopedic Surgery 2163327404 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134260FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard L Smith MD PA CurrentSince Jul 7, 2019 Accepting new patients
Richard L Smith MD PA CurrentSince Jul 7, 2019 Accepting new patients
Laser Spine Institute of Arizona, LLC Past Accepting new patients

Locations

138 E Gore St
Orlando, FL 32806
Phone (407) 649-7673

1724 33rd St
Ste 200
Orlando, FL 32839
Phone (407) 385-1551

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1639150204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11603 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264306",
            "telephone_number": "775-786-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 33RD ST STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32839",
            "telephone_number": "407-385-1551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 N Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895034723",
            "country_code": "US",
            "telephone_number": "775-786-3040",
            "fax_number": "775-786-1358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENMUIR",
        "first_name": "BRETT",
        "middle_name": "GORDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "FL",
            "license": "ME134260",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME134260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505993",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN",
            "identifier": "H87507",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN",
            "identifier": "39576",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS PROVIDER #",
            "identifier": "9947",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.