NPIMap

Individual provider Active NPI

Edward Christopher Brennan Jr., D.O.

  • Cardiovascular Disease Physician
  • Camp Hill, PA
National Provider Identifier
1831192004
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS004551L Issued in PA
Practice address
875 Poplar Church Rd
Camp Hill, PA 17011-2203
Phone
(717) 724-6450
Fax
(717) 724-6451
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OS004551L PA Primary

Addresses

Primary practice location

875 Poplar Church Rd
Camp Hill, PA 17011-2203

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 2

IdentifierTypeStateIssuer
0010495800003MedicaidPA
060052170OtherRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebrennan122010@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060601000152 PA Practitioner - Cardiovascular Disease (Cardiology) 5991772170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Philadelphia College of Osteopathic Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

875 Poplar Church Rd
Suite 400
Camp Hill, PA 17011-2203
Phone (717) 724-6450

Hospital & facility affiliations

  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004
  • Penn State Health Hampden Medical Center Hospital, Enola, PA, CCN 390336
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS004551LPAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC Cardiovascular Disease Past Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

875 Poplar Church Rd
Ste 400
Camp Hill, PA 17011
Phone (717) 975-0900

20 Capital Dr
Ste 100
Harrisburg, PA 17110
Phone (717) 724-6397

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

Organizations & group practices 4

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 11

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1831192004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 POPLAR CHURCH RD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112203",
            "telephone_number": "717-724-6450",
            "fax_number": "717-724-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "EDWARD",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS004551L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010495800003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060052170",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebrennan122010@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "875 Poplar Church Rd",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170112203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.