Individual provider Active NPI

Christopher J Brouillette, MD

  • Family Medicine Physician
  • Englewood, FL
National Provider Identifier
1891779013
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0076609 Issued in FL
Practice address
3000 S McCall Rd
Englewood, FL 34224-8616
Phone
(941) 841-4200
Fax
(941) 841-4201
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0076609 FL Primary

Addresses

Primary practice location

3000 S McCall Rd
Englewood, FL 34224-8616

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

891 Outer Rd Ste A
Orlando, FL 32814-6605
Phone (407) 895-4737

Other identifiers 1

IdentifierTypeStateIssuer
7627094OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20040112000488 FL Practitioner - Family Practice 7416857735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

3000 S McCall Rd
Englewood, FL 34224-8616
Phone (941) 406-9029

Hospital & facility affiliations

  • Millennium Home Care LLC Home health agency, Port Charlotte, FL, CCN 109401
  • HCA Florida Healthcare at Home Home health agency, PT Charlotte, FL, CCN 108013
  • Aveanna Home Health Home health agency, Sarasota, FL, CCN 108480
  • Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • HCA Florida Englewood Hospital Hospital, Englewood, FL, CCN 100267

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0076609FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
Orlando Physicians Network Inc Family Medicine CurrentSince Apr 28, 2020 Accepting new patients
Dover Shores Family Practice Family Medicine PastSince Jul 31, 2022 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients
Traditions Family Medicine, LLC Family Medicine PastSince Oct 31, 2021 Accepting new patients

Locations

3000 S McCall Rd
Englewood, FL 34224
Phone (941) 406-9029

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

891 Outer Rd
Ste A
Orlando, FL 32814
Phone (407) 895-4737

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: cbrouillette26144@orlandohealth.medalliesdirect.net
  • Direct secure messaging: christopher.brouillette.1@4290.direct.athenahealth.com

Organizations & group practices 7

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 6

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1891779013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342248616",
            "telephone_number": "941-841-4200",
            "fax_number": "941-841-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "891 Outer Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328146605",
            "country_code": "US",
            "telephone_number": "407-895-4737",
            "fax_number": "321-203-4610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0076609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7627094",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

Verify at the official NPI Registry.