NPIMap

Individual provider Active NPI

Brendan Michael Corcoran

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1750736484
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2021-02333 Issued in NC
Practice address
3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117
Phone
(980) 208-1704
NPI assigned
May 2, 2016
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 01085917A IN
Diagnostic Radiology Physician 2085R0202X 2021-02333 NC Primary

Addresses

Primary practice location

3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117

Mailing address

3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117
Phone (980) 208-1704

Other practice location 1

550 University Blvd Rm 663
Indianapolis, IN 46202-5149
Phone (317) 944-1866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220223000163 NC Practitioner - Diagnostic Radiology 9739450370 Reassigns benefits to 1 organization
I20220902001455 OH Practitioner - Diagnostic Radiology 9739450370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mecklenburg Radiology Associates PAGroup PAC ID 6800789587, 95 clinicians

Practice addresses (Care Compare)

3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-2117
Phone (704) 332-1291

4357 N Oval St
Dublin, OH 43017-5002
Phone (980) 208-1704

6582 Pepperell LN
Cincinnati, OH 45236-2238
Phone (704) 332-1291

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.03 of 100Reported as group
Quality
98.89
Improvement activities
40
Cost
72.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-02333NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mecklenburg Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Columbus Radiology Corp Diagnostic Radiology Past Accepting new patients

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 8

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1750736484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR STE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112117",
            "telephone_number": "980-208-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR STE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112117",
            "telephone_number": "980-208-1704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd Rm 663",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-944-1866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "BRENDAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01085917A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2021-02333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.