Individual provider Active NPI

Brandon Olaf Eilertson, MD

  • Infectious Disease Physician
  • Brooklyn, NY
National Provider Identifier
1922283597
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
274041 Issued in NY
Practice address
450 Clarkson Ave
MSC 56
Brooklyn, NY 11203-2012
Phone
(216) 313-2726
NPI assigned
Jan 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 002649 GA
Infectious Disease Physician 207RI0200X 274041 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
MSC 56
Brooklyn, NY 11203-2012

Mailing address

330 W 58TH St
Apt 11F
New York, NY 10019-1827
Phone (216) 313-2726

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190722000010 MD Practitioner - Infectious Disease 0749406304 Reassigns benefits to 1 organization
I20250602000030 DC Practitioner - Internal MedicinePractitioner - Infectious Disease 0749406304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002649GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Internal Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Apr 23, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jun 17, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jun 17, 2019 Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

4000 Garden City Dr
Fl 4
Hyattsville, MD 20785
Phone (227) 229-8532

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 4

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 1

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": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1922283597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST",
            "address_2": "APT 11F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191827",
            "telephone_number": "216-313-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "MSC 56",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "216-313-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILERTSON",
        "first_name": "BRANDON",
        "middle_name": "OLAF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-02",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "002649",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "274041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1701 Twin Springs Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212273553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.