Individual provider Active NPI

Lauren Elizabeth Brolund, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1669825873
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109657 Issued in FL
Practice address
875 Outer Rd
Orlando, FL 32814-6652
Phone
(407) 895-8818
NPI assigned
Jul 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109657 FL Primary

Addresses

Primary practice location

875 Outer Rd
Orlando, FL 32814-6652

Mailing address

1000 S Orlando Ave
Apartment A4
Maitland, FL 32751-6476
Phone (407) 353-4806

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171117001483 FL Practitioner - Physician Assistant 5092071449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reflections Dermatology and Center for Skin Care PLLCGroup PAC ID 2062509987, 5 clinicians

Practice addresses (Care Compare)

875 Outer Rd
Orlando, FL 32814-6652
Phone (407) 895-8818

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109657FLMDPhysician Assistant

Organizations & group practices 1

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1669825873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S ORLANDO AVE",
            "address_2": "APARTMENT A4",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516476",
            "telephone_number": "407-353-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OUTER RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146652",
            "telephone_number": "407-895-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROLUND",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.