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DR. DERALD E BRACKMANN MD
NPI 1508876699
Otolaryngology - Otology & Neurotology in Los Angeles, CA

Active since August 09, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
2100 W 3RD ST STE 111, LOS ANGELES, CA 90057(213) 483-9930(213) 483-0905 Get Directions Write a Review

NPPES record last updated: September 3, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Derald E Brackmann Md NPPES

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

DR. DERALD E BRACKMANN MD (NPI 1508876699) is an individual otology & neurotology provider in Los Angeles, California, licensed in California (G11124) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1962).

NPPES Registry Identity

NPI1508876699
Entity TypeIndividualMale
Primary Taxonomy207YX0901X
Provider Legal NameDR. DERALD E BRACKMANNCredential: MD
Location Address2100 W 3RD ST STE 111Los Angeles, CA 90057-1999
Mailing Address2100 W 3rd St Ste 111Los Angeles, CA 90057-1999 · (213) 483-9930 · Fax (213) 483-0905
Phone(213) 483-9930
Fax(213) 483-0905
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1962
Enumeration DateAugust 9, 2006
Last NPPES UpdateSeptember 3, 2013
✔ NPI 1508876699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Otology & NeurotologyAllopathic & Osteopathic Physicians
Taxonomy Code207YX0901X
License✔ Licensed in CA · G11124
Definition

An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone.

2100 W 3RD ST STE 111, Los Angeles, CA 90057
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINA38229
Medicaid00G111240CA
Medicare PINWG11124B

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Derald E Brackmann Md 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 ID6103809892
PECOS Enrollment IDI20110628000660
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 20-29 minutes 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
452 services359 patients
New patient office or other outpatient visit, 30-44 minutes 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
208 services208 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
196 services181 patients
Exam of ear using a microscope 92504
An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.
189 services174 patients
Established patient office or other outpatient visit, 30-39 minutes 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
159 services143 patients
New patient office or other outpatient visit, 45-59 minutes 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
71 services71 patients

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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

Other Providers at the Same Location NPPES 10

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

REBECCA JEAN CIHOCKI M.S. CCC-A
Audiologist
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 353-7052
ROBERT RATHBURN M.S.
Audiologist
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 353-7052
ALLEN JOHN SENNE AUD
Audiologist
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 483-9930
DR. JANE M. GAY AU.,D.
Audiologist
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 989-7400
MS. CAITHLIN E. MACNEIL AU.D.
Audiologist
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 483-9930
WADAD J SHALHUB
Audiologist-Hearing Aid Fitter
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 483-9930
HOUSE CLINIC
Audiologist
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 353-7052
DR. KEVIN ALBERT PENG M.D.
Otolaryngology (Otology & Neurotology)
2100 W 3RD ST STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 483-9930

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 Derald Brackmann's NPI number?

The NPI number for Derald Brackmann is 1508876699. It was assigned to this individual provider in the NPPES registry on August 9, 2006.

Where is Derald Brackmann located?

Derald Brackmann practices at 2100 W 3rd St Ste 111, Los Angeles, CA 90057. The listed phone number is (213) 483-9930.

What is Derald Brackmann's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otology & Neurotology, with taxonomy code 207YX0901X.

Is Derald Brackmann enrolled in Medicare?

Yes. Derald Brackmann 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.

When was this NPI record last updated?

The NPPES record for Derald Brackmann was last updated on September 3, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.