Individual provider Active NPI

Brandi Schuller, PA-C

  • Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1700417615
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114493 Issued in FL
Practice address
901 45TH St.
Kimmel BLDG
West Palm Beach, FL 33407-2413
Phone
(561) 844-5255
Fax
(561) 844-5245
NPI assigned
Jan 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9114493 FL Primary
Physician Assistant 363A00000X 085007524 IL

Addresses

Primary practice location

901 45TH St.
Kimmel BLDG
West Palm Beach, FL 33407-2413

Mailing address

901 45TH St
Kimmel BLDG
West Palm Beach, FL 33407-2413
Phone (561) 844-5255

Other practice location 1

1200 E Broadway
Columbia, MO 65215-1000
Phone (636) 634-6120

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
I20210622001083 FL Practitioner - Physician Assistant 8022419530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.65 of 100Reported as group
Quality
66.27
Promoting interoperability
100
Improvement activities
40
Cost
72.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085007524ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services II, LLC CurrentSince Jun 15, 2021 Accepting new patients
Tenet Florida Physician Services II, LLC Physician Assistant CurrentSince Jun 15, 2021 Accepting new patients

Locations

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

Interoperability endpoints

  • Direct secure messaging: brandi.van.booven.1@13023.direct.athenahealth.com

Organizations & group practices 2

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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1700417615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "address_2": "KIMMEL BLDG",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-5255",
            "fax_number": "561-844-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH ST.",
            "address_2": "KIMMEL BLDG",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-5255",
            "fax_number": "561-844-5245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652151000",
            "country_code": "US",
            "telephone_number": "636-634-6120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULLER",
        "first_name": "BRANDI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114493",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.