Individual provider Active NPI

Stephen Benjamin Brown, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1710508494
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9786 Issued in GA
Practice address
210 E Derenne Ave
Savannah, GA 31405-6736
Phone
(912) 644-5300
NPI assigned
May 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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 9786 GA Primary

Addresses

Primary practice location

210 E Derenne Ave
Savannah, GA 31405-6736

Mailing address

8201 Pinellas Dr
Bluffton, SC 29910-4133
Phone (843) 705-9401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200706000655 GA Practitioner - Physician Assistant 7113340431 Reassigns benefits to 2 organizations
I20201001003215 SC Practitioner - Physician Assistant 7113340431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optim Orthopedics LLC 101 clinicians
Tattnall Hospital Company LLC 47 clinicians

Practice addresses (Care Compare)

101 W Mulberry Blvd
Suite 140
Savannah, GA 31407-3507
Phone (912) 748-5111

17007 Hwy 67
Statesboro, GA 30458-2426
Phone (912) 681-2500

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1000

257 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-8990

602 E Long St
Claxton, GA 30417-5914
Phone (912) 739-3275

810 Towne Park Dr
Suite 200
Rincon, GA 31326-5167
Phone (912) 826-2533

8201 Pinellas Dr
Bluffton, SC 29910-4133
Phone (843) 705-9401

Hospital & facility affiliations

  • Candler Hospital Hospital, Savannah, GA, CCN 110024

Merit-based Incentive Payment System (MIPS)

Final score
54.22 of 100Reported as group
Quality
71.46
Promoting interoperability
0
Improvement activities
40
Cost
59.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9786GAMDGeneral Practice Dentistry
3568SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optim Orthopedics, LLC CurrentSince May 7, 2020 Accepting new patients
Tattnall Hospital Company, LLC CurrentSince Oct 1, 2020 Accepting new patients
Optim Orthopedics, LLC CurrentSince May 26, 2020 Accepting new patients
Optim Orthopedics, LLC CurrentSince May 7, 2020 Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients
Tattnall Hospital Company, LLC Past Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Tattnall Hospital Company LLC Past Accepting new patients

Locations

821 S Main St
Ste C
Baxley, GA 31513
Phone (912) 367-5486

242 Industrial Blvd
Dublin, GA 31021
Phone (478) 272-3140

790 Veterans Parkway
Ste 111
Hinesville, GA 31313
Phone (912) 368-3868

961 E Winthrope Ave
Millen, GA 30442
Phone (478) 982-0120

247 S Main St
#A
Reidsville, GA 30453
Phone (912) 352-4490

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

119B Victory Dr
Swainsboro, GA 30401
Phone (478) 237-7676

102 Rocky Ford Rd
Sylvania, GA 30467
Phone (912) 564-2155

209 Mims Rd
#A
Sylvania, GA 30467
Phone (912) 564-5236

1724 Old Reynolds St
#B
Waycross, GA 31501

8201 Pinellas Dr
Bluffton, SC 29910
Phone (843) 705-9401

Interoperability endpoints

  • Direct secure messaging: stephen.brown.1@16403.direct.athenahealth.com

Organizations & group practices 22

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.

View all 22

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": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1710508494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 PINELLAS DR",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299104133",
            "telephone_number": "843-705-9401",
            "fax_number": "843-705-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STEPHEN",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.