Individual provider Active NPI

Michael Eugene Brown, MD

  • Family Medicine Physician
  • East Berlin, PA
National Provider Identifier
1780614214
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD026151E Issued in PA
Practice address
105 4TH St
East Berlin, PA 17316-9638
Phone
(717) 846-4644
Fax
(717) 259-7262
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD026151E PA Primary

Addresses

Primary practice location

105 4TH St
East Berlin, PA 17316-9638

Mailing address

1803 Mount Rose Ave
Suite B3
York, PA 17403-3026
Phone (717) 851-1405

Other identifiers 11

IdentifierTypeStateIssuer
80707OtherPAUNISON-WMG
01059601OtherPACAPITAL BLUE CROSS-WMG
233283OtherPAMAMSI-WMG
30031OtherPAJOHNS HOPKINS
49366OtherPAGEISINGER
P002798OtherPAGATEWAY-WMG
1142345OtherPAAMERIHEALTH MERCY-WMG
162704OtherPAHIGHMARK BLUE SHIELD
4555802OtherPAAETNA
542989OtherMDCAREFIRST MD BCBS
000913572MedicaidPA

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

LicenseStateTypeSpecialty
MD026151EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1780614214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033026",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 4TH ST",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173169638",
            "telephone_number": "717-846-4644",
            "fax_number": "717-259-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD026151E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "80707",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "01059601",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-WMG",
            "identifier": "233283",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "30031",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "49366",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "P002798",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "1142345",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "162704",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4555802",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "542989",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000913572",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Berlin, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.