Individual provider Active NPI

Brandon S Fletcher, M.D.

  • Family Medicine Physician
  • Longwood, FL
National Provider Identifier
1982897112
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME115245 Issued in FL
Practice address
771 Ciara Creek CV
Longwood, FL 32750-4659
Phone
(407) 543-1270
Fax
(407) 813-1311
NPI assigned
Aug 21, 2007
Last updated
Jun 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME115245 FL Primary

Addresses

Primary practice location

771 Ciara Creek CV
Longwood, FL 32750-4659

Mailing address

771 Ciara Creek CV
Longwood, FL 32750-4659
Phone (407) 543-1270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2019 through Apr 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME115245FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Medical Associates, PA Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drfletcher@primarycareathome.officeally.direct

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1982897112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 CIARA CREEK CV",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504659",
            "telephone_number": "407-543-1270",
            "fax_number": "407-813-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 CIARA CREEK CV",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504659",
            "telephone_number": "407-543-1270",
            "fax_number": "407-813-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "BRANDON",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME115245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.