Individual provider Active NPI

Brandon Edward Locklear, M.D.

  • Obstetrics & Gynecology Physician
  • Longwood, FL
National Provider Identifier
1740447531
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME132159 Issued in FL
Practice address
550 E State Road 434
Longwood, FL 32750-5222
Phone
(407) 635-3026
Fax
(321) 203-4614
NPI assigned
May 20, 2008
Last updated
May 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME132159 FL Primary
Obstetrics & Gynecology Physician 207V00000X 200800781 NC

Addresses

Primary practice location

550 E State Road 434
Longwood, FL 32750-5222

Mailing address

550 E State Road 434
Longwood, FL 32750-5222
Phone (407) 635-3026

Other identifiers 2

IdentifierTypeStateIssuer
5909548MedicaidNC
2022368OtherMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927003639 FL Practitioner - Obstetrics/Gynecology 9830263086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Brody School of Medicine at East Carolina University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

83 W Miller St
Orlando, FL 32806-2031
Phone (321) 841-8555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200800781NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2017 Accepting new patients
Orlando Health Medical Group Inc Obstetrics & Gynecology CurrentSince Sep 1, 2017 Accepting new patients

Locations

550 E State Road 434
Longwood, FL 32750
Phone (407) 262-5710

550 E State Road 434
Fl 2
Longwood, FL 32750

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

4401 S Orange Ave
Ste 113
Orlando, FL 32806

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

7404 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 381-7387

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: blocklear26578@orlandohealth.medalliesdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1740447531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505222",
            "telephone_number": "407-635-3026",
            "fax_number": "321-203-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505222",
            "telephone_number": "407-635-3026",
            "fax_number": "321-203-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKLEAR",
        "first_name": "BRANDON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME132159",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200800781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909548",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2022368",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.