Active NPI
Michael Brennan, MD
- Psychiatry Physician
- Mesa, AZ
National Provider Identifier
1760429856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 12629
- Practice address
- 868 E University Dr
Mesa, AZ 85203-8033 - Phone
- (480) 969-6955
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 12629 | AZ | Primary |
Addresses
Primary practice location
868 E University Dr
Mesa, AZ 85203-8033
Mailing address
868 E University Dr
Mesa, AZ 85203-8033
Phone (480) 969-6955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12629 | AZ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313107200000",
"number": "1760429856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "868 E UNIVERSITY DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852038033",
"telephone_number": "480-969-6955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "868 E UNIVERSITY DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852038033",
"telephone_number": "480-969-6955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2011-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "12629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.