Individual provider Active NPI

Joseph Peter Brabham Jr.

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1801355847
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112113 Issued in FL
Practice address
322 W Bearss Ave
Tampa, FL 33613-1228
Phone
(813) 575-0477
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 9112113 FL Primary
Psychiatry Physician 2084P0800X 9112113 FL

Addresses

Primary practice location

322 W Bearss Ave
Tampa, FL 33613-1228

Mailing address

21814 Waverly Shores LN
Land O Lakes, FL 34637-7562
Phone (813) 461-9395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190514001321 FL Practitioner - Physician Assistant 1658614722 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Florida Post Acute Medical Services 1 PAGroup PAC ID 2567729395, 57 clinicians
Ca Pacs 2 Medical Group IncGroup PAC ID 4981954476, 27 clinicians

Practice addresses (Care Compare)

1908 E 131St Ave
Tampa, FL 33612-4690
Phone (813) 977-7878

2029 Professional Ctr Dr
Orange Park, FL 32073-4461
Phone (865) 693-1000

322 W Bearss Ave
Tampa, FL 33613-1228
Phone (813) 575-0477

4325 Southpoint Blvd
Jacksonville, FL 32216-6166
Phone (904) 245-7620

4406 Melton Ave
Tampa, FL 33614-7218
Phone (865) 693-1000

490 S Old Wire Rd
Wildwood, FL 34785-5001
Phone (865) 693-1000

5905 Pine Hill Rd
Port Richey, FL 34668-6615
Phone (727) 845-0527

8319 W Pocahontas Ave
Tampa, FL 33615-2820
Phone (813) 506-2713

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9112113FLMDPhysician Assistant

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1801355847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21814 WAVERLY SHORES LN",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346377562",
            "telephone_number": "813-461-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W BEARSS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131228",
            "telephone_number": "813-575-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABHAM",
        "first_name": "JOSEPH",
        "middle_name": "PETER",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112113",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "9112113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.