MEDICARE: DR. BRANDON CASSIDY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT022165	OH

General Provider Information

NPI Number	:	1336090950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON CASSIDY

Provider Business Mailing Address
First Line	:	379 HARTFORD DR
Second Line	:
City	:	EASTLAKE
State	:	OH
Zip	:	44095-1733
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11900 FAIRHILL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1062
Country	:	US
Telephone Number	:	216-983-8030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ DR. BRANDON CASSIDY ” Practice Location

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