Individual provider Active NPI

Robert Harrison Brandon II, D.O.

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1902120942
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
243361 Issued in NY
Practice address
470 E Fordham Rd
Bronx, NY 10458-5108
Phone
(718) 960-3805
Fax
(718) 960-3806
NPI assigned
Mar 19, 2010
Last updated
Mar 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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 243361 NY Primary

Addresses

Primary practice location

470 E Fordham Rd
Bronx, NY 10458-5108

Mailing address

470 E Fordham Rd
Bronx, NY 10458-5108
Phone (718) 960-3805

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
I20110628000425 FL Practitioner - Emergency MedicinePractitioner - Family Practice 9739367400 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243361NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
St. Joseph Emergency Medical Physicians PA CurrentSince Oct 1, 2020 Accepting new patients
W4P LLC CurrentSince Sep 15, 2019 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

700 Medical Blvd
Englewood, FL 34223
Phone (941) 473-5001

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951

10461 Quality Dr
Spring Hill, FL 34609
Phone (352) 688-3002

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1902120942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585108",
            "telephone_number": "718-960-3805",
            "fax_number": "718-960-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585108",
            "telephone_number": "718-960-3805",
            "fax_number": "718-960-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "ROBERT",
        "middle_name": "HARRISON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.