Anna Karin Brenner, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY10702 Issued in FL

Practice address

6767 N Wickham Rd Ste 306
Melbourne, FL 32940-2025

Phone

(321) 751-1925

Fax

(321) 751-9261

NPI assigned

Jan 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Anna Shuman Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychology Associates of Brevard PLCGroup PAC ID 9638078025, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Psychology Associates of Brevard PLC

  • Clinical Psychologist
  • Melbourne, FL
  • NPI 1922200278
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1740810084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM RD STE 306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402025",
            "telephone_number": "321-751-1925",
            "fax_number": "321-751-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM RD STE 306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402025",
            "telephone_number": "321-751-1925",
            "fax_number": "321-751-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "ANNA",
        "middle_name": "KARIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pab.2011@ymail.com",
            "affiliation": "N",
            "address_1": "6767 N Wickham Rd Ste 306",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329402025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pab.2011@ymail.com",
            "affiliation": "N",
            "address_1": "6767 N Wickham Rd Ste 306",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329402025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "SHUMAN",
            "credential": "PSY.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Audrius J Bredikis, M.D.
• Larry Jay Brendle, R.PH.
• Holly Brennan, RD
• Robert F Brennan, MD
• Tara Jeanne Brennan, LCSW
• Brevard Accident & Work Injury Centers LLC
• Brevard Alzheimer'S Foundation, Inc.
• Brevard Alzheimer'S Foundation, Inc.
• Brevard Anesthesia Services PA
• Brevard Assisted Living LLC

• Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.