Joyce M Brackebusch, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD20476 Issued in OR

Practice address

146 E Hospital Dr Ste 200
West Columbia, SC 29169-4800

Phone

(803) 936-7530

Fax

(803) 936-7532

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in OR, SC, WA, ID4 enrollments

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 4

Specialty

Otolaryngology

Education

Oregon Health Sciences University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palouse Specialty Physicians PSGroup PAC ID 0345569166, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331
• Gritman Medical Center Hospital, Moscow, ID, CCN 131327

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmbracke@yourcarecommunity.org
• Direct secure messaging: jbrackebush715485@direct.ochin.org

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.

• Oregon Ear, Nose and Throat, P.C.

  • Otolaryngology Physician
  • Eugene, OR
  • NPI 1790863041
  Medicare reassignment NPD Authorized official
• Palouse Specialty Physicians, P.S.

  • Otolaryngology Physician
  • Pullman, WA
  • NPI 1760889265

  ID

  Medicare reassignment Care Compare group NPD
• Lexington Health Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Columbia, SC
  • NPI 1710634753
  Medicare reassignment NPD
• Lexington Health Inc

  • Otolaryngology Physician
  • West Columbia, SC
  • NPI 1013514330
  NPD
• Lexington Health Inc

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1942190988
  NPD
• Palouse Specialty Physicians, P.S.

  • Hematology & Oncology Physician
  • Moscow, ID
  • NPI 1770298333
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Care Compare affiliation
• Gritman Medical Center Inc.

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590

  Hospital

  Care Compare affiliation
• Public Hospital District #1-a of Whitman County

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1710065271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-791-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 E HOSPITAL DR STE 200",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694800",
            "telephone_number": "803-936-7530",
            "fax_number": "803-936-7532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 S Garden Way",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018173",
            "country_code": "US",
            "telephone_number": "541-349-9333",
            "fax_number": "541-349-0082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305472",
            "country_code": "US",
            "telephone_number": "541-768-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKEBUSCH",
        "first_name": "JOYCE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD20476",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "89330",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150605",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrackebusch240258@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973305472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrackebusch162582@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "146 E Hospital Dr Ste 200",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrackenbusch162582@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "146 E Hospital Dr Ste 200",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott B Boyd, M.D.
• Matison L. Boyer, MD
• Lakisha M. Boykin-Wright, APRN
• Jeffrey C Boyne, M.D.
• William Walter Brabham, MD
• Roger Barry Bradley, RPH
• Valeri Bradley
• Kara B Bradshaw, PT
• William Harold Bragdon Jr., MD
• Hope A. Brainard, DO

• Otolaryngology Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Otolaryngology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.