Individual provider Active NPI

Joshua M Braveman, M.D.

  • Colon & Rectal Surgery Physician
  • South Bend, IN
National Provider Identifier
1639151053
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
01100172A Issued in IN
Practice address
621 Memorial Dr Ste 502
South Bend, IN 46601-1075
Phone
(574) 647-5875
Fax
(574) 647-5878
NPI assigned
Nov 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 01100172A IN Primary
Colon & Rectal Surgery Physician 208C00000X 35083205 OH
Colon & Rectal Surgery Physician 208C00000X C209109 CA

Addresses

Primary practice location

621 Memorial Dr Ste 502
South Bend, IN 46601-1075

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-3725

Other practice location 1

621 Memorial Dr Ste 511
South Bend, IN 46601-1075
Phone (574) 544-5580

Other practice location 2

500 Arcade Ave Ste 320
Elkhart, IN 46514-2485
Phone (574) 523-7900

Other practice location 3

1020 High Rd
Bremen, IN 46506-1093
Phone (574) 309-9967

Other practice location 4

4972 Red Bank Rd
Galena, OH 43021-8602
Phone (614) 542-9142

Other identifiers 3

IdentifierTypeStateIssuer
2095726MedicaidMA
2426271MedicaidOH
300135547MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbraveman14640@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080919000321 OH Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 3678522406 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Tufts University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

285 E State St
Suite 640
Columbus, OH 43215-4322
Phone (614) 566-7444

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35083205OHMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JMB MD LLC Colon & Rectal Surgery Current Accepting new patients
Ohiohealth Corporation CurrentSince Aug 1, 2008 Accepting new patients
Ohiohealth Corporation Colon & Rectal Surgery CurrentSince Aug 1, 2008 Accepting new patients
Ohiohealth Corporation Past Accepting new patients
Umass Memorial Medical Group Inc Past Accepting new patients

Locations

285 E State St
Ste 620
Columbus, OH 43215
Phone (614) 469-7621

285 E State St
Ste 640
Columbus, OH 43215
Phone (614) 566-0744

Dept L3652
Columbus, OH 43260

700 E Broad St
Fl 1
Columbus, OH 43215
Phone (614) 917-1670

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5350 Frantz Rd
Dublin, OH 43016

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1132444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1639151053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR STE 502",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011075",
            "telephone_number": "574-647-5875",
            "fax_number": "574-647-5878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Memorial Dr Ste 511",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011075",
            "country_code": "US",
            "telephone_number": "574-544-5580",
            "fax_number": "574-544-5579",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Arcade Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142485",
            "country_code": "US",
            "telephone_number": "574-523-7900",
            "fax_number": "574-523-7909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 High Rd",
            "address_purpose": "LOCATION",
            "city": "Bremen",
            "state": "IN",
            "postal_code": "465061093",
            "country_code": "US",
            "telephone_number": "574-309-9967",
            "fax_number": "574-309-9968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4972 Red Bank Rd",
            "address_purpose": "LOCATION",
            "city": "Galena",
            "state": "OH",
            "postal_code": "430218602",
            "country_code": "US",
            "telephone_number": "614-542-9142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAVEMAN",
        "first_name": "JOSHUA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-20",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IN",
            "license": "01100172A",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "OH",
            "license": "35083205",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "C209109",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2095726",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2426271",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300135547",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbraveman14640@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "285 E State St",
            "address_2": "Ste 640",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432154354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.