Individual provider Active NPI

Gregory Brennan, M.D.

  • Gastroenterology Physician
  • Mansfield, TX
National Provider Identifier
1689017105
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
Q4044 Issued in TX
Practice address
647 N Miller Rd Ste B
Mansfield, TX 76063-6180
Phone
(817) 760-7969
Fax
(817) 760-7976
NPI assigned
Apr 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Q4044 TX Primary

Addresses

Primary practice location

647 N Miller Rd Ste B
Mansfield, TX 76063-6180

Mailing address

PO Box 35629
Dallas, TX 75235-0629
Phone (214) 424-2213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190729000813 TX Practitioner - Gastroenterology 2466737259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Tufts University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Digestive Disease Consultants, PLLC 616 clinicians

Practice addresses (Care Compare)

505 S Nolen Dr
A
Southlake, TX 76092-9167
Phone (817) 424-1525

Hospital & facility affiliations

  • Texas Health Hospital Mansfield Hospital, Mansfield, TX, CCN 670309

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy71
Upper gastrointestinal (GI) endoscopy for acid reflux104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141634CAMDMarriage & Family Therapist
Q4044TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Jun 3, 2019 Accepting new patients
Texas Digestive Disease Consultants, PLLC Single Specialty Current Accepting new patients
Texas Digestive Disease Consultants PLLC Single Specialty CurrentSince Jun 3, 2019 Accepting new patients

Locations

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

920 Highway 287 N
Ste 308
Mansfield, TX 76063
Phone (817) 473-7197

647 N Miller Rd
Ste B
Mansfield, TX 76063
Phone (817) 760-7969

505 S Nolen Dr
#A
Southlake, TX 76092
Phone (817) 424-1525

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1689017105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35629",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350629",
            "telephone_number": "214-424-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 N MILLER RD STE B",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636180",
            "telephone_number": "817-760-7969",
            "fax_number": "817-760-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "Q4044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.