Individual provider Active NPI

Eva Ballard Brennan, PA-C

  • Surgical Physician Assistant
  • Bradenton, FL
National Provider Identifier
1821760455
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9115867 Issued in FL
Practice address
8000 Sr 64 E
Bradenton, FL 34212
Phone
(941) 792-1404
Fax
(941) 761-0712
NPI assigned
Oct 1, 2021
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9115867 FL Primary

Addresses

Primary practice location

8000 Sr 64 E
Bradenton, FL 34212

Mailing address

8000 Sr 64 E
Bradenton, FL 34212
Phone (941) 792-1404

Other identifiers 1

IdentifierTypeStateIssuer
B2WNWOtherFLBCB

Other names 1

  • Eva B Roberts Former name

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
I20220812000141 FL Practitioner - Physician Assistant 4880092444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

8000 Sr 64
Bradenton, FL 34212
Phone (941) 792-1404

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50.36 of 100Reported as group
Quality
43.71
Promoting interoperability
0
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115867FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine of Southwest Florida PA CurrentSince Sep 12, 2022 Accepting new patients

Locations

6202 17th Ave W
Bradenton, FL 34209

8000 State Road 64 E
Bradenton, FL 34212
Phone 94179214043315

8340 Lakewood Ranch Blvd
Ste 300
Lakewood Ranch, FL 34202
Phone (941) 316-8200

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1821760455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 SR 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34212",
            "telephone_number": "941-792-1404",
            "fax_number": "941-761-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 SR 64 E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34212",
            "telephone_number": "941-792-1404",
            "fax_number": "941-761-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "EVA",
        "middle_name": "BALLARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9115867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCB",
            "identifier": "B2WNW",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVA",
            "last_name": "ROBERTS",
            "middle_name": "B",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.