Provider Demographics
NPI:1568460509
Name:ELIAS, BRIAN M (DPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:ELIAS
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 142ND AVE N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2822
Mailing Address - Country:US
Mailing Address - Phone:727-796-6900
Mailing Address - Fax:727-669-8417
Practice Address - Street 1:508 MEETING ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7535
Practice Address - Country:US
Practice Address - Phone:727-796-6900
Practice Address - Fax:727-669-8417
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004352L213E00000X, 213ES0000X, 213ES0103X
PASC213EP1101X, 213ER0200X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA308924OtherUPMC
PA0016609550007Medicaid
PA39998OtherGEISINGER
PA1931764OtherHIGHMARK BC/BS
PA5939150001Medicare NSC
PA39998OtherGEISINGER