Ethan D Brubaker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6262 Veterans Pkwy
Columbus, GA 31909-3540

Phone

(706) 324-6661

NPI assigned

Jan 31, 2019

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 AL, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment Care Compare group
• Hughston Clinic, P.C.

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1164461190

  AL

  Medicare reassignment NPD
• Benning Hospitalist Services, LLC

  • Hospitalist Physician
  • Columbus, GA
  • NPI 1215442173
  Medicare reassignment
• Hughston Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Newnan, GA
  • NPI 1902682347
  NPD

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1861957169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093540",
            "telephone_number": "706-324-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093540",
            "telephone_number": "706-324-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Calumet Center Rd",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302416705",
            "country_code": "US",
            "telephone_number": "706-884-3274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "512 N Shady Ln",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363032991",
            "country_code": "US",
            "telephone_number": "334-699-5747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4340 Kings Way",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316026921",
            "country_code": "US",
            "telephone_number": "229-333-9736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Oakland Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "GA",
            "postal_code": "317637201",
            "country_code": "US",
            "telephone_number": "229-420-1839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "ETHAN",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Mechelle Brown
• Tracie Brown
• Trudy Brown
• Katherine Brownstein
• Arthur Broxton
• Bruce a Boretsky DMD, LLC
• Pamela Bruce
• Terry Bruce
• Samantha Meghan Bruffy
• Jack Benjamin Brumberg, OD

• Physician Assistant in Columbus, GA
• Providers in Columbus, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.