Individual provider Active NPI

Jeffrey Einar Brink, M.D.

  • Otolaryngology Physician
  • Leesburg, FL
National Provider Identifier
1942206206
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2019-02814 Issued in NC
Practice address
601 E Dixie Ave Ste 901
Leesburg, FL 34748-7308
Phone
(352) 728-2404
Fax
(352) 787-7401
NPI assigned
Jun 22, 2005
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME72544 FL
Otolaryngology Physician 207Y00000X 2019-02814 NC Primary

Addresses

Primary practice location

601 E Dixie Ave Ste 901
Leesburg, FL 34748-7308

Mailing address

601 E Dixie Ave Ste 901
Leesburg, FL 34748-7308
Phone (352) 728-2404

Other practice location 1

701 Bryant St
Statesville, NC 28677-4142
Phone (704) 380-2742

Other practice location 2

740 Bryant St
Statesville, NC 28677-4143
Phone (704) 878-6272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC, SC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20081030000702 FL Practitioner - Otolaryngology 1850460940 Reassigns benefits to 1 organization
I20200304002699 NC Practitioner - Otolaryngology 1850460940 Reassigns benefits to 2 organizations
I20200806000672 SC Practitioner - Otolaryngology 1850460940 Reassigns benefits to 1 organization
Practice locations: Fort Mill, SC

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Florida College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

740 Bryant St
Statesville, NC 28677-4143
Phone (704) 878-6272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72544FLMDOtolaryngology Physician
2019-02814NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaches Ear, Nose and Throat, PA Current Accepting new patients
Iredell Physician Network LLC Otolaryngology CurrentSince Apr 1, 2025 Accepting new patients
Cornerstone Ear Nose & Throat PA Specialist CurrentSince Mar 16, 2020 Accepting new patients
Lake ENT & FPS, PA Specialist CurrentSince Jan 1, 2023 Accepting new patients
Iredell Physician Network, LLC CurrentSince Apr 1, 2025 Accepting new patients
Iredell Physician Network LLC Current Accepting new patients
Cornerstone Ear Nose & Throat PA Otolaryngology CurrentSince Mar 19, 2023 Accepting new patients
Painfree Physical Therapy Inc Past Accepting new patients
Iredell Physician Network LLC Past Accepting new patients

Locations

3200 3rd St S
Ste 101
Jax Bch, FL 32250
Phone (904) 247-4070

601 E Dixie Ave
Ste 901
Leesburg, FL 34748
Phone (352) 728-2404

1819 Salk Ave
Tavares, FL 32778
Phone (352) 343-7279

1501 N US Highway 441
Ste 1402
The Villages, FL 32159
Phone (352) 396-0350

8035 Providence Rd
Ste 320
Charlotte, NC 28277
Phone (704) 752-7575

1107 Reynolds St
Monroe, NC 28112
Phone (704) 289-8220

701 Bryant St
Statesville, NC 28677
Phone (704) 380-2711

740 Bryant St
Statesville, NC 28677
Phone (704) 873-7330

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

7666 Charlotte Hwy
Ste 220
Indian Land, SC 29707
Phone (704) 752-7575

Organizations & group practices 9

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.

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1942206206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE STE 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487308",
            "telephone_number": "352-728-2404",
            "fax_number": "352-787-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE STE 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487308",
            "telephone_number": "352-728-2404",
            "fax_number": "352-787-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Bryant St",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286774142",
            "country_code": "US",
            "telephone_number": "704-380-2742",
            "fax_number": "704-380-2747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 Bryant St",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286774143",
            "country_code": "US",
            "telephone_number": "704-878-6272",
            "fax_number": "704-878-6273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRINK",
        "first_name": "JEFFREY",
        "middle_name": "EINAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME72544",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2019-02814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.