NPIMap

Organization Active NPI

Pulmonary Associates of Brandon PA

  • Pulmonary Disease Physician
  • Brandon, FL
National Provider Identifier
1811932239
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY ASSOCIATES OF BRANDON PA
Practice address
910 Oakfield Dr
Suite 102
Brandon, FL 33511-4925
Phone
(813) 681-4413
Fax
(813) 684-7299
NPI assigned
Jun 19, 2006
Last updated
Dec 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Authorized official

Name
Mrs. Donna S Williams
Title
Coordinator
Phone
(813) 681-8813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

910 Oakfield Dr
Suite 102
Brandon, FL 33511-4925

Mailing address

910 Oakfield Dr
Suite 102
Brandon, FL 33511-4925
Phone (813) 681-4413

Other identifiers 1

IdentifierTypeStateIssuer
1811932239OtherFLNPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040607001082 FL Part B Supplier - Clinic/Group Practice 4385626837 Receives reassigned benefits from 11 practitioners
Practice locations: Brandon, FL; Ruskin, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0861478Pulmonary Associates of Brandon910 Oakfield Drive #102, Brandon, FL 33511Certificate of waiverJan 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pulmonary Associates of Brandon3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1723 S Kings Ave
Brandon, FL 33511
Phone (813) 681-4413

910 Oakfield Dr
Brandon, FL 33511
Phone (813) 681-4413

910 Oakfield Dr
Ste 102
Brandon, FL 33511
Phone (813) 681-4413

4020 Sun City Center Blvd
Ste 5
Sun City Center, FL 33573
Phone (813) 633-3100

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1811932239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 OAKFIELD DR",
            "address_2": "SUITE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114925",
            "telephone_number": "813-681-4413",
            "fax_number": "813-684-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 OAKFIELD DR",
            "address_2": "SUITE 102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114925",
            "telephone_number": "813-681-4413",
            "fax_number": "813-684-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY ASSOCIATES OF BRANDON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "813-681-8813",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1811932239",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.