Breanne M Jaqua, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

008620 Issued in AZ

Practice address

1501 N Gilbert Rd
Gilbert, AZ 85234-2390

Phone

(480) 728-4100

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Breanne M Hirshman Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Dignity Community Care

  dba Chandler Regional Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Medicare reassignment NPD
• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment NPD
• Chandler Regional Medical Center

  dba CRMC Trauma Services

  • Emergency Care Clinic/Center
  • Chandler, AZ
  • NPI 1871910968
  NPD (past)
• Mercy Health Physicians-North LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1609000769
  NPD (past)
• Mercy Health System Northern

  • Pediatric Cardiology Physician
  • Toledo, OH
  • NPI 1992748743
  NPD (past)

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1821520313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N GILBERT RD FL 1",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342390",
            "telephone_number": "480-728-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N GILBERT RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342390",
            "telephone_number": "480-728-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Cherry St Fl 1",
            "address_2": "Emergency Medicine Residency - St. Vincent Medical Cent",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "419-251-4724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Cherry Street",
            "address_2": "ACC Trauma Clinic",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43608",
            "country_code": "US",
            "telephone_number": "419-251-4283",
            "fax_number": "419-251-0814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAQUA",
        "first_name": "BREANNE",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.013802",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "008620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNE",
            "last_name": "HIRSHMAN",
            "middle_name": "M",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Janbou, DMD
• Jekyung Jang, MT-BC
• Janice Motoike, PH.D., P.L.L.C.
• Lauren Elizabeth Janke
• Janus RX LLC
• Sadie Angela Jardine
• Mehul Jarecha, DC
• Jared Crouse Counseling PLLC
• Mikkel Jarman
• William C Jarman, D.C.

• Emergency Medicine Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.