Individual provider Active NPI

Brett W Engbrecht

  • Pediatric Surgery Physician
  • Indianapolis, IN
National Provider Identifier
1932165479
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD060010L Issued in PA
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-8857
Fax
(317) 338-8858
NPI assigned
Apr 25, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD060010L PA
Pediatric Surgery Physician 2086S0120X MD060010L PA Primary

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

8402 Harcourt Rd Ste 830
Indianapolis, IN 46260-2096
Phone (317) 338-8857

Other identifiers 1

IdentifierTypeStateIssuer
1013866800001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IN2 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
I20050517000503 PA Practitioner - General SurgeryPractitioner - Pediatric Medicine 1658312913 Reassigns benefits to 1 organization
I20191009000902 IN Practitioner - General Surgery 1658312913 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatric Surgery CurrentSince Nov 1, 2019 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2016 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jul 1, 2016 Accepting new patients
St Vincent Pediatric Subspecialties CurrentSince Nov 1, 2019 Accepting new patients
Pinnacle Health Medical Services Surgery Current Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8402 Harcourt Rd
Ste 830
Indianapolis, IN 46260
Phone (317) 338-8857

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

Interoperability endpoints

  • Direct secure messaging: brett.engbrecht.1@7598.direct.athenahealth.com

Organizations & group practices 5

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1932165479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 830",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602096",
            "telephone_number": "317-338-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-8857",
            "fax_number": "317-338-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGBRECHT",
        "first_name": "BRETT",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD060010L",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "PA",
            "license": "MD060010L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013866800001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.