Active NPI
Jamal Davon Brazan
- Aerospace Medicine Physician
- Bethesda, MD
National Provider Identifier
1699232025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Aerospace Medicine Physician
- License
- 0101270621
- Practice address
- 8901 Rockville Pike
Bethesda, MD 20889-5095 - Phone
- (301) 295-4000
- NPI assigned
- Feb 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 0101270621 | VA | Primary |
Addresses
Primary practice location
8901 Rockville Pike
Bethesda, MD 20889-5095
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190802002992 | VA | Order and Referring Only - General Surgery | 9335476068 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101270621 | VA | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1699232025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8901 ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208895095",
"telephone_number": "301-295-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZAN",
"first_name": "JAMAL",
"middle_name": "DAVON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-21",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "VA",
"license": "0101270621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.