Individual provider Active NPI

Alexandra Zoe Brandenburg, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1700035474
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2732 Issued in SC
Practice address
104 Innovation Dr
Greenville, SC 29607-5253
Phone
(864) 603-6200
Fax
(877) 379-2919
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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 PA2732 SC Primary

Addresses

Primary practice location

104 Innovation Dr
Greenville, SC 29607-5253

Mailing address

104 Innovation Dr
Greenville, SC 29607-5253
Phone (864) 603-6200

Other practice location 1

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (864) 255-1304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180109002020 SC Practitioner - Physician Assistant 3274789250 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520

104 Innovation Dr
Greenville, SC 29607-5253
Phone (864) 603-6300

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2732SCMDPhysical Therapist
PA2732SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalen Inpatient Care, PC CurrentSince Jan 12, 2021 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 9, 2024 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Jul 16, 2023 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Jul 16, 2023 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 9, 2024 Accepting new patients
Llano Regional Hospital Physician Assistant Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

317 Saint Francis Dr
Ste 220B
Greenville, SC 29601
Phone (864) 255-1304

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

104 Innovation Dr
Greenville, SC 29607
Phone (864) 255-1000

Interoperability endpoints

  • Direct secure messaging: abrandenburg1149689@direct.bsmhealth.org

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 6

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1700035474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 INNOVATION DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075253",
            "telephone_number": "864-603-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 INNOVATION DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075253",
            "telephone_number": "864-603-6200",
            "fax_number": "877-379-2919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Saint Francis Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296013955",
            "country_code": "US",
            "telephone_number": "864-255-1304",
            "fax_number": "877-379-2919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "ALEXANDRA",
        "middle_name": "ZOE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA2732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.