Individual provider Active NPI

Brandon William Schroth, MPA

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1760759104
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1102201 Issued in GA
Practice address
357051 Nasni
Commander Naval Air Forces
San Diego, CA 92135-7051
Phone
(619) 545-1148
Fax
(619) 767-7417
NPI assigned
Nov 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1102201 GA Primary

Addresses

Primary practice location

357051 Nasni
Commander Naval Air Forces
San Diego, CA 92135-7051

Mailing address

P.O. Box 357051 Nasni
Commander Naval Air Forces
San Diego, CA 92135-7051
Phone (619) 545-1148

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1102201GAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1760759104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 357051 NASNI",
            "address_2": "COMMANDER NAVAL AIR FORCES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921357051",
            "telephone_number": "619-545-1148",
            "fax_number": "619-767-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357051 NASNI",
            "address_2": "COMMANDER NAVAL AIR FORCES",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921357051",
            "telephone_number": "619-545-1148",
            "fax_number": "619-767-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROTH",
        "first_name": "BRANDON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "1102201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.