CORNERSTONE MEDICAL CARE OF BRANDON LLC
NPI 1124038989
Clinic/Center - Primary Care in Brandon, FL
About Cornerstone Medical Care Of Brandon Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CORNERSTONE MEDICAL CARE OF BRANDON LLC (NPI 1124038989) is a healthcare organization registered as a primary care in Brandon, Florida and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through January 16, 2027, maintains a secondary practice location in Sun City Center, and lists Julio A Enriquez, Managing Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cornerstone Medical Care Of Brandon Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
17Medicare enrollment records show 17 clinicians reassign Medicare billing to Cornerstone Medical Care Of Brandon LLC, which bills Medicare for the services they deliver. Of these, 12 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (17)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D1063549
Cornerstone Medical Care Of Brandon, LLC · Sun City Center, FLCertificate of Waiver 10D1004978
Cornerstone Medical Care Of Brandon, LLC · Brandon, FLFrequently 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 Cornerstone Medical Care Of Brandon LLC's NPI number?
The NPI number for Cornerstone Medical Care Of Brandon LLC is 1124038989. It was assigned to this organization in the NPPES registry on August 8, 2006.
Where is Cornerstone Medical Care Of Brandon LLC located?
Cornerstone Medical Care Of Brandon LLC is located at 500 Vonderburg Dr E Tower Ste 102, Brandon, FL 33511. The listed phone number is (813) 681-5658.
What is Cornerstone Medical Care Of Brandon LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Cornerstone Medical Care Of Brandon LLC enrolled in Medicare?
Yes. Cornerstone Medical Care Of Brandon LLC is registered in the Medicare PECOS enrollment system.
When is Cornerstone Medical Care Of Brandon LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Cornerstone Medical Care Of Brandon LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 5 Medicare specialties reassign their Medicare billing to Cornerstone Medical Care Of Brandon LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (6), Nurse Practitioner (6) and Family Practice (3). Of these, 12 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Cornerstone Medical Care Of Brandon LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D1063549) is associated with this NPI, valid through January 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Cornerstone Medical Care Of Brandon LLC accept?
Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Cornerstone Medical Care Of Brandon LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Cornerstone Medical Care Of Brandon LLC was last updated on June 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Cornerstone Medical Care Of Brandon Llc · NPI 1124038989
Primary Care organization in Brandon, Florida. Organization record, active in the CMS NPPES registry since August 8, 2006.
## Identity
- **NPI:** 1124038989 (Entity type: Organization)
- **Enumerated:** August 8, 2006
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Julio Enriquez, MANAGING MEMBER
## Practice location
- **Address:** 500 VONDERBURG DR, E TOWER STE 102, Brandon, FL 33511-5964
- **Phone:** (813) 681-5658 · **Fax:** (813) 681-5250
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 17 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (6), Nurse Practitioner (6), Family Practice (3); 12 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 17, 2021
- **Other identifiers:** Medicaid 267292800 (FL)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124038989) · Data from the CMS NPPES public registry.