1. Home
  2. Directory
  3. Ohio
  4. Dayton
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

EVAN BRANDENBURG
NPI 1063202216
Student in an Organized Health Care Education/Training Program in Dayton, OH

Active since May 10, 2025PECOS Enrolled
30 E APPLE ST STE 6258, DAYTON, OH 45409(937) 208-8000 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 14, 2025, May 10, 2025 (2 updates tracked since 2025).

About Evan Brandenburg NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN BRANDENBURG (NPI 1063202216) is an individual student in an organized health care education/training program in Dayton, Ohio, licensed in Ohio (57.258989) and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063202216
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameEVAN BRANDENBURG
Location Address30 E APPLE ST STE 6258Dayton, OH 45409-2932
Mailing Address30 E Apple St Ste 6258Dayton, OH 45409-2932
Phone(937) 208-8000
Sole ProprietorNo
Enumeration DateMay 10, 2025
Last NPPES UpdateMay 14, 20252 updates tracked since enumeration
NPPES CertifiedMay 14, 2025
✔ NPI 1063202216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in OH · 57.258989
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
30 E APPLE ST STE 6258, Dayton, OH 45409
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evan Brandenburg is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NGA TRAN DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
AUSTIN RAY NELSON MD
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-2951
NICHOLAS AARON BURPEE MD
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
AKMAL SALAM
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
DR. GREGORY R. SEMON D.O.
Surgery
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-5055
JASON CHRISTOPHER PRADARELLI MD, MS
Surgery
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
DR. CHEYENNE NICOLE WONG DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
LEE PEARSON GORE
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 775-2934

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evan Brandenburg's NPI number?

The NPI number for Evan Brandenburg is 1063202216. It was assigned to this individual provider in the NPPES registry on May 10, 2025.

Where is Evan Brandenburg located?

Evan Brandenburg practices at 30 E Apple St Ste 6258, Dayton, OH 45409. The listed phone number is (937) 208-8000.

What is Evan Brandenburg's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Evan Brandenburg enrolled in Medicare?

Yes. Evan Brandenburg is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Evan Brandenburg was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.