Active NPI
Brandon Olaf Eilertson, MD
- Infectious Disease Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 274041
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002649 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New 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 | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | 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.
-
- Health Maintenance Organization
- Halethorpe, MD
- NPI 1043378656
-
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC, Internal Medicine
-
- Health Maintenance Organization
- MC Lean, VA
- NPI 1376815472
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Towson, MD
- NPI 1124374079
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.