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MR. JEREMY WILLIAM BROUILLETTE D.P.M.
NPI 1477969806
Podiatrist in Southlake, TX

Active since July 07, 2014PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
ACADEMY FOOT & ANKLE SPECIALISTS, 1940 E. STATE HWY 114, SUITE 150, SOUTHLAKE, TX 76092(817) 424-3668(817) 442-8637 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 6, 2025, May 9, 2017 (2 updates tracked since 2017).

About Mr. Jeremy William Brouillette D.p.m. NPPES

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

MR. JEREMY WILLIAM BROUILLETTE D.P.M. (NPI 1477969806) is an individual podiatrist in Southlake, Texas, licensed in Texas (692085) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1477969806
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameMR. JEREMY WILLIAM BROUILLETTECredential: D.P.M.
Location AddressACADEMY FOOT & ANKLE SPECIALISTS, 1940 E. STATE HWY 114, SUITE 150Southlake, TX 76092-6526
Mailing Address1940 E. State Hwy 114, Suite 150Southlake, TX 76092-6526 · (817) 424-3668 · Fax (817) 442-8637
Phone(817) 424-3668
Fax(817) 442-8637
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJuly 7, 2014
Last NPPES UpdateMarch 6, 20252 updates tracked since enumeration
✔ NPI 1477969806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in TX · 692085
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X · License 10448 (WV), 0103301199 (VA)
ACADEMY FOOT & ANKLE SPECIALISTS, Southlake, TX 76092
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jeremy William Brouillette D.p.m. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749558252
PECOS Enrollment IDI20170623001800, I20170911000241, I20250828001826
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Jeremy Brouillette reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Foot And Ankle Clinic Of The Virginias Inc
958 mi
Podiatrist
401 ROGERS ST
Princeton, WV 24740
  • Reassigned Medicare billing, Virginia and West Virginia enrollments
  • 12 clinicians in this Medicare group
NPI 1740227909 (800) 292-3008
Foot And Ankle Specialists Of The Mid-Atlantic, LLC
1,076 mi
Podiatrist
3801 WAKE FOREST RD STE 100
Raleigh, NC 27609
  • Reassigned Medicare billing, Virginia enrollment
  • 66 clinicians in this Medicare group
NPI 1073804712 (301) 933-7133
Healthdrive Podiatry Group, PC
1,214 mi
Podiatrist
6700 ALEXANDER BELL DR, SUITE 200
Columbia, MD 21046
  • Reassigned Medicare billing, District of Columbia enrollment
  • 17 clinicians in this Medicare group
NPI 1548685258 (888) 964-6681

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76092 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500
DME-Orthotic Devices · category DF000N
4 suppliers35 claims69 services$56.35 avg. paid by Medicare
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512
DME-Orthotic Devices · category DF000N
4 suppliers29 claims164 services$24.05 avg. paid by Medicare
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf L1902
DME-Orthotic Devices · category DF003N
5 suppliers19 claims22 services$64.87 avg. paid by Medicare
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
4 suppliers12 claims12 services$239.19 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

MR. FAHAD ASLAM D.P.M.
Podiatrist
ACADEMY FOOT & ANKLE SPECIALISTS, 1940 E. STATE HWY 114, SUITE 150
SOUTHLAKE, TX 76092
Tarrant County (817) 424-3668
MR. DANIEL THOMAS PIERINI D.P.M.
Podiatrist
ACADEMY FOOT & ANKLE SPECIALISTS, 1940 E. STATE HWY 114, SUITE 150
SOUTHLAKE, TX 76092
Tarrant County (817) 424-3668
MR. DANIEL JOSHUA CAIRNS D.P.M.
Podiatrist
ACADEMY FOOT & ANKLE SPECIALISTS, 1940 E STATE HWY 114 SUITE 150
SOUTHLAKE, TX 76092
Tarrant County (817) 424-3668

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 Jeremy Brouillette's NPI number?

The NPI number for Jeremy Brouillette is 1477969806. It was assigned to this individual provider in the NPPES registry on July 7, 2014.

Where is Jeremy Brouillette located?

Jeremy Brouillette practices at Academy Foot & Ankle Specialists 1940 E. State Hwy 114, Suite 150, Southlake, TX 76092. The listed phone number is (817) 424-3668.

What is Jeremy Brouillette's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Jeremy Brouillette enrolled in Medicare?

Yes. Jeremy Brouillette is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jeremy Brouillette's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeremy Brouillette reassigns Medicare benefits to 3 organizations: Foot And Ankle Clinic Of The Virginias Inc (Princeton, WV), Foot And Ankle Specialists Of The Mid-Atlantic, LLC (Raleigh, NC) and Healthdrive Podiatry Group, PC (Columbia, MD). Each 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 Jeremy Brouillette's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeremy Brouillette accept?

Health plans from Blue Cross and Blue Shield of Texas and Oscar Health list Jeremy Brouillette 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 Jeremy Brouillette was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.