Duane Thomas Brooks, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5366T Issued in CA

Practice address

110 Chestnut St
Mount Shasta, CA 96067-2209

Phone

(530) 926-2033

Fax

(530) 926-3722

NPI assigned

May 23, 2005

Last updated

Nov 28, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Shasta Vision Group an Optometric Corporation

  • Optometrist
  • Mount Shasta, CA
  • NPI 1669697348
  Medicare reassignment

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1063415065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CHESTNUT ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672209",
            "telephone_number": "530-926-2033",
            "fax_number": "530-926-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CHESTNUT ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672209",
            "telephone_number": "530-926-2033",
            "fax_number": "530-926-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DUANE",
        "middle_name": "THOMAS",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "777T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5366T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0053660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Bottoms, MIN.
• Norman Bowers, MFT
• Donna Bringenberg
• Carolyn Briody
• Eriksson Brioso
• Nicholas Patrick Brown, DO
• Robert C Brucker, C.R.N.A.
• Christopher James Brunell, LMFT
• Sophia Mishelle Bullington
• Jennifer Michelle Burleigh, PHARMD

• Optometrist in Mount Shasta, CA
• Providers in Mount Shasta, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.