Shaun Brancheau, DO

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

008804 Issued in AZ

Practice address

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709

Phone

(805) 123-7154

Fax

(480) 512-3715

NPI assigned

Mar 25, 2010

Last updated

Oct 28, 2024By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner Primary Care Physicians Arizona LLCGroup PAC ID 6406020155, 236 clinicians

BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
• Banner Ironwood Medical Center Hospital, Queen Creek, AZ, CCN 030130

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shaun.brancheau.p79@direct.kootenai.nextgenshare.com

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.

• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1659640902
  Medicare reassignment Care Compare group NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1417238908
  NPD
• Banner Primary Care Physicians Arizona LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
  • NPI 1790306066
  NPD

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

• Banner Home Care-Arizona

  • Home Health Agency
  • Sun City, AZ
  • NPI 1023051927
  Care Compare affiliation
• Banner Ironwood Medical Center

  • General Acute Care Hospital
  • Queen Creek, AZ
  • NPI 1124341672
  Care Compare affiliation

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1891019493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21772 S ELLSWORTH LOOP RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427709",
            "telephone_number": "805-123-7154",
            "fax_number": "480-512-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21772 S ELLSWORTH LOOP RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427709",
            "telephone_number": "805-123-7154",
            "fax_number": "480-512-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCHEAU",
        "first_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AZ",
            "license": "008804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaun.brancheau.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1701 Lincoln Way",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol S Bradford, NP-C
• Riannon Bradshaw, CD
• Tyler John Bradshaw, D.C.
• Chris M Braegger, PHARMD
• Nichole Brainard, RN BSN
• Luis Javier Bravo Pagan, MD
• Brighter Days Mental Health and Wellness
• Alexa Brightman
• Maranda Briney, MPH, AT, ATC
• Scottlund Wayne Britton, MD

• Adult Medicine Physician in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Adult Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.