Individual provider Active NPI

Brandi Louise Spencer, P.A.

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1811383631
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09461 Issued in TX
Practice address
1717 N Garrett Ave
Dallas, TX 75206-7514
Phone
(214) 827-6880
Fax
(214) 827-0520
NPI assigned
Apr 8, 2015
Last updated
Apr 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09461 TX Primary

Addresses

Primary practice location

1717 N Garrett Ave
Dallas, TX 75206-7514

Mailing address

1717 N Garrett Ave
Dallas, TX 75206-7514
Phone (214) 827-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190426000752 TX Practitioner - Physician Assistant 6608118492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

125 E Grubb Dr
109 Wellmed at Mesquite
Mesquite, TX 75149-3402
Phone (972) 285-6349

301 Tanger Dr
Suite 221
Terrell, TX 75160-6654
Phone (972) 563-6493

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Mar 11, 2019 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Mar 11, 2019 Accepting new patients
Andrew B Burke DO Associated PastSince Oct 1, 1992 Accepting new patients

Locations

3310 Live Oak St
Ste 30
Dallas, TX 75204
Phone (972) 942-3410

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: brandi.spencer@wellmed.eclinicaldirectplus.com

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 1

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1811383631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N GARRETT AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067514",
            "telephone_number": "214-827-6880",
            "fax_number": "214-827-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N GARRETT AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067514",
            "telephone_number": "214-827-6880",
            "fax_number": "214-827-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "BRANDI",
        "middle_name": "LOUISE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.