Individual provider Active NPI

Albert David Brauer, M.D.

  • Family Medicine Physician
  • Republic, WA
National Provider Identifier
1902875099
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00021780 Issued in WA
Practice address
10 Ros Cir
Republic, WA 99166-5002
Phone
(509) 775-3153
Fax
(509) 775-8929
NPI assigned
Mar 14, 2006
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21780 WA
Family Medicine Physician 207Q00000X MD00021780 WA Primary

Addresses

Primary practice location

10 Ros Cir
Republic, WA 99166-5002

Mailing address

36 Klondike Rd
Republic, WA 99166-9701
Phone (509) 775-3153

Other identifiers 1

IdentifierTypeStateIssuer
1390905MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21780WAMDEmergency Medicine Physician
MD00021780WAMDFamily Medicine Physician
025209WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Health Center Past Accepting new patients
Washington Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Columbia Valley Emergency Physicians LLC Emergency Medicine Past Accepting new patients

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1902875099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 KLONDIKE RD",
            "city": "REPUBLIC",
            "state": "WA",
            "postal_code": "991669701",
            "telephone_number": "509-775-3153",
            "fax_number": "509-775-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ROS CIR",
            "city": "REPUBLIC",
            "state": "WA",
            "postal_code": "991665002",
            "telephone_number": "509-775-3153",
            "fax_number": "509-775-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUER",
        "first_name": "ALBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "21780",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00021780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1390905",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Republic, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.