Individual provider Active NPI

Raphael A Brandao, DMD

  • Dentist
  • Cape Coral, FL
National Provider Identifier
1932755691
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26709 Issued in FL
Practice address
316 Del Prado Blvd S
Cape Coral, FL 33990-1710
Phone
(239) 226-4620
Fax
(239) 458-2267
NPI assigned
Aug 16, 2019
Last updated
May 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN26709 FL Primary
Dentist 122300000X DE60967757 WA

Addresses

Primary practice location

316 Del Prado Blvd S
Cape Coral, FL 33990-1710

Mailing address

PO Box 919771
Orlando, FL 32891-7966
Phone (239) 278-3600

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220523001794 FL Practitioner - Dentist 0042697526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN26709FLMDDentist
DE60967757WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson.Ferguson,Steinhart. James.PLLC PastSince Aug 1, 2019 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1932755691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917966",
            "telephone_number": "239-278-3600",
            "fax_number": "239-479-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901710",
            "telephone_number": "239-226-4620",
            "fax_number": "239-458-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDAO",
        "first_name": "RAPHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26709",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60967757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.