Individual provider Active NPI

Brian A Lippman, PA

  • Medical Physician Assistant
  • Clearwater, FL
National Provider Identifier
1942297973
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9100950 Issued in FL
Practice address
1840 N Highland Ave
Clearwater, FL 33755-2138
Phone
(727) 442-3001
Fax
(727) 467-9106
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9100950 FL Primary

Addresses

Primary practice location

1840 N Highland Ave
Clearwater, FL 33755-2138

Mailing address

1840 N Highland Ave
Clearwater, FL 33755-2138
Phone (727) 442-3001

Other identifiers 2

IdentifierTypeStateIssuer
290946400MedicaidFL
970013098OtherFLRAILROAD MEDICARE

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000337 FL Practitioner - Physician Assistant 5193857860 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Med Center Countryside Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brian.lippman@fmcoc.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1942297973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 N HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552138",
            "telephone_number": "727-442-3001",
            "fax_number": "727-467-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 N HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337552138",
            "telephone_number": "727-442-3001",
            "fax_number": "727-467-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPMAN",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9100950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290946400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970013098",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.