NPIMap

Individual provider Active NPI

Douglas Brenneman, D.O.

  • Family Medicine Physician
  • Brogue, PA
National Provider Identifier
1669468831
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS012261 Issued in PA
Practice address
2500 Delta Rd
Brogue, PA 17309-9106
Phone
(717) 927-8434
Fax
(717) 927-6274
NPI assigned
Sep 23, 2005
Last updated
Jan 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS012261 PA Primary

Addresses

Primary practice location

2500 Delta Rd
Brogue, PA 17309-9106

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dbrenneman62212@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040514000511 PA Practitioner - Family Practice 9830189505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

2500 Delta Rd
Brogue, PA 17309-9106
Phone (717) 927-8434

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.61 of 100Reported as group
Quality
83.98
Promoting interoperability
100
Improvement activities
40
Cost
78.06

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Family Medicine Associates of York, LLC Family Medicine CurrentSince Oct 1, 2004 Accepting new patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Memorial Enterprises Inc Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Pinnacle Health Medical Services Family Medicine Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

2500 Delta Rd
Brogue, PA 17309
Phone (717) 927-8434

366 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-1900

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

55 Old Farm Ln
Shrewsbury, PA 17361
Phone (717) 235-4893

1232 Greensprings Dr
York, PA 17402
Phone (717) 207-4800

1785 4th Ave
York, PA 17403
Phone (717) 849-5474

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1669468831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "fax_number": "717-221-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 DELTA RD",
            "city": "BROGUE",
            "state": "PA",
            "postal_code": "173099106",
            "telephone_number": "717-927-8434",
            "fax_number": "717-927-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNEMAN",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbrenneman62212@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2500 Delta Rd",
            "city": "Brogue",
            "state": "PA",
            "country_code": "US",
            "postal_code": "173099106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brogue, PA

Sources for this page

Verify at the official NPI Registry.