Brendan Alexander Miccio, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

13813 Issued in GA

Practice address

1120 15TH St
Augusta, GA 30912-0004

Phone

(706) 721-4951

NPI assigned

Jun 11, 2022

Last updated

Jun 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Emergency Medicine

Education

Lake Erie Col of Osteopathic Medicine, Bradenton, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sandhills Emergency Physicians PAGroup PAC ID 8729062609, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034
• Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Sandhills Emergency Physicians PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Pinehurst, NC
  • NPI 1003853409
  Care Compare group
• Wellstar Medical Group, LLC

  dba WellStar South Cobb Ob/Gyn

  • Obstetrics & Gynecology Physician
  • Austell, GA
  • NPI 1134425283
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902
  Care Compare affiliation
• Firsthealth of the Carolinas, Inc

  dba Firsthealth Bariatric Center

  • Obesity Medicine (Internal Medicine) Physician
  • Pinehurst, NC
  • NPI 1740463967

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc

  dba Firsthealth Regional EMS System

  • Land Ambulance
  • Pinehurst, NC
  • NPI 1871610378

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc.

  dba FirstHealth Cancer Center

  • Oncology Clinic/Center
  • Pinehurst, NC
  • NPI 1417010422

  Hospital

  Care Compare affiliation
• Firsthealth of the Carolinas, Inc.

  dba FH Moore Regional Hospital (Acute)

  • General Acute Care Hospital
  • Pinehurst, NC
  • NPI 1740208081
  Care Compare affiliation

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1841920071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 OAKRIDGE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092437",
            "telephone_number": "201-675-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCIO",
        "first_name": "BRENDAN",
        "middle_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "13813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Metzger, DO
• Drew Emerson Metzger, ACVREP CERTIFIED
• Kurt Thomas Metzler, DDS, MS
• Audrey R Meyer, PA-C
• Erin Mezzetti, PA
• Michael B. Boyd, D.M.D., P.C.
• Michael J. Cohen, M.D., P.C.
• Michael Ridlehoover DMD LLC
• Madeline Michael
• Marie Michel

• Emergency Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.
• 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.