Brandon Augustine, DC
Individual provider Active NPI Chiropractor · Hazleton, PA
NPI 1962043000 · NPPES record last updated Jun 2, 2020
Key facts
- NPI
- 1962043000
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC011510 (PA)
- Practice address
- 1730 E Broad St
Hazleton, PA 18201-5657 - Phone
- (570) 497-4150
- NPI assigned
- Sep 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191203001394 | PA | Practitioner - Chiropractic | 9931532090 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC011510 | PA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Home Health & Rehab LLC | Current |
Accepting new patients | |
| Sacco Chiropractic PC | Chiropractor | Current |
Accepting new patients |
Locations
1730 E Broad St
Hazleton, PA 18201
Phone (570) 455-3656
1730 E Broad St
Ste 1
Hazleton, PA 18201
Phone (570) 459-2226
250 S River St
Plains, PA 18705
Phone (570) 822-4848
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC011510 | PA | Yes |
Addresses
Primary practice location
1730 E Broad St
Hazleton, PA 18201-5657
Mailing address
1730 E Broad St
Hazleton, PA 18201-5657
Phone (570) 497-4150
Other providers in Hazleton, PA
- Ap02 Inc
- Apo2
- Arn, Inc.
- Richard Gene Ashford
- Timothy J. Atkinson
- Tequilla Tavockious Ayinla
- B. Bittar, M.D., P.C.
- Joseph Vito Bafile Jr.
- Laura Bailey
- Nicole Lee Balchune
All providers in Hazleton, PA · Chiropractor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.