Brooke Erin Breitenbach, PA-C

Individual provider Active NPI Physician Assistant · Hermitage, PA

NPI 1063661742 · NPPES record last updated Oct 12, 2016

Key facts

NPI
1063661742
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
MA051710 (PA)
Practice address
2501 Shenango Valley Fwy
Suite 1
Hermitage, PA 16148-2536
Phone
(724) 983-1820
Fax
(724) 983-1822
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn a. Colaiacovo, M.D., P.C. (3 clinicians)

Practice addresses (Care Compare)

2501 Shenango Valley Fwy
Suite 1
Hermitage, PA 16148-2536
Phone 72498318206

Merit-based Incentive Payment System (MIPS)

Final score
77.83 of 100 (group)
Quality
82.74
Promoting interoperability
51
Improvement activities
40
Cost
84.18

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090626000338 PA Practitioner - Physician Assistant 4385795699 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051710PAMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051710 PA Yes

Addresses

Primary practice location

2501 Shenango Valley Fwy
Suite 1
Hermitage, PA 16148-2536

Mailing address

2501 Shenango Valley Fwy
Suite 1
Hermitage, PA 16148-2536
Phone (724) 983-1820

Other names

  • Miss Brooke Erin Penwell Former name

Other providers in Hermitage, PA

All providers in Hermitage, PA · Physician Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.