David J Brockman, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301060697 Issued in MI

Practice address

53760 Generations Dr
South Bend, IN 46635-1539

Phone

(574) 247-4444

Fax

(574) 243-5555

NPI assigned

May 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ascension Medical Group Promed

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment NPD
• Ascension Medical Group Promed

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1720009954

  Physical Medicine & Rehabilitation

  NPD
• Promed Healthcare

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1013961929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53760 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351539",
            "telephone_number": "574-247-4444",
            "fax_number": "574-243-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53760 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351539",
            "telephone_number": "574-247-4444",
            "fax_number": "574-243-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01040664A",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301060697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10093210",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M87690002",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brighter Strides ABA in LLC
• David Briner
• Norma Angelica Briseno Alonso
• Sarah Bristol, RBT
• Tayler Lynn Britton, BS
• Aubrey Brogdon, SLP
• James F Brogle, PH.D.
• Susan M Brokaw, PT
• Jade Brom, RBT
• Brookdale Senior Living Communities, Inc.

• Physical Medicine & Rehabilitation Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.