Brandon Tarl Hamisch, D.O.
Individual provider Active NPI Family Medicine Physician · Corpus Christi, TX
NPI 1841245552 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1841245552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- L9227 (TX)
- Practice address
- 5802 Saratoga Blvd Ste 130
Corpus Christi, TX 78414-4252 - Phone
- (361) 696-6200
- Fax
- (361) 985-0305
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Owned or controlled facilities with NPI records 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Texas HSC, College of Osteopathic Med, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shea Physical Therapy Specialists LLC
Christus Trinity Clinic Texas
Practice addresses (Care Compare)
5440 Everhart Rd
Suite 1
Corpus Christi, TX 78411-4838
Phone (361) 994-5224
5802 Saratoga Blvd
Suite 150
Corpus Christi, TX 78414-4254
Phone (361) 986-4600
620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900
630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560
PO Box
Suite 846098
Dallas, TX 75284-6098
Hospital & facility affiliations
- Angel Bright Home Health Inc
- Christus Spohn Hospital Corpus Christi
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040830000699 | TX | Practitioner - Family Practice | 1153396577 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Family Medicine | Current |
Accepting new patients |
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Citizens Medical Center County of Victoria | Past | Accepting new patients | |
| Crockett Clinic LLP | Family Medicine | Past | Accepting new patients |
Locations
3030 North St
Ste 420
Beaumont, TX 77702
Phone (409) 835-2900
5802 Saratoga Blvd
Ste 200
Corpus Christi, TX 78414
Phone (361) 696-6200
5802 Saratoga Blvd
Ste 130
Corpus Christi, TX 78414
Phone (361) 696-6200
5802 Saratoga Blvd
Ste 150
Corpus Christi, TX 78414
Phone (361) 985-1888
1415 Santa Fe St
Corpus Christi, TX 78404
Phone (361) 861-9760
1122 E Loop 304
Crockett, TX 75835
Phone (936) 544-2157
1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Interoperability endpoints
- thamisch245503@christushealth.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | L9227 | TX | Yes |
Addresses
Primary practice location
5802 Saratoga Blvd Ste 130
Corpus Christi, TX 78414-4252
Mailing address
919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711
Other practice location 1
5802 Saratoga Blvd Ste 200
Corpus Christi, TX 78414-4252
Phone (361) 986-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P02601747 | Other | TX | MCRR |
| 167840106 | Medicaid | TX | |
| 167840108 | Medicaid | TX | |
| 130864507 | Medicaid | TX | |
| 1L5691 | Other | TX | MEDICARE |
Other providers in Corpus Christi, TX
- Michael Halpert
- Salena Hamberlin
- Joyce L Hamende
- Chanse Hamilton
- Patricia Anne Hamilton
- Sheri Dawn Hamit
- Hamlin Pharmacy
- Noreen W. Hammerick
- Deborah A Hammond
- Christopher Kevin Hampton
All providers in Corpus Christi, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.