Brooktiete Asseres, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2013-01617 Issued in NC

Practice address

3569 Willow Green Dr
Apex, NC 27502-2507

Phone

(240) 338-1418

NPI assigned

Jun 2, 2010

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 15

Medicare fee-for-service enrollment

Enrolled in NC, MD2 enrollments

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 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DLP Maria Parham Physician Practices, LLC

  dba Maria Parham Primary Care

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1215273628
  Medicare reassignment NPD
• Granville Health System

  dba Granville CRNA Group

  • Certified Registered Nurse Anesthetist
  • Oxford, NC
  • NPI 1275638512
  Medicare reassignment NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  NC

  Medicare reassignment NPD
• Meritus Medical Center Inc

  dba Meritus Palliative Care

  • Nurse Practitioner
  • Hagerstown, MD
  • NPI 1205176393
  Medicare reassignment NPD
• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624

  Pediatrics

  Medicare reassignment NPD
• Mission Health Community Multispecialty Providers, LLC

  • Anesthesiology Physician
  • Asheville, NC
  • NPI 1457719130
  Medicare reassignment
• DLP Maria Parham Physician Practices LLC

  • Rural Health Clinic/Center
  • Henderson, NC
  • NPI 1578256749
  NPD
• DLP Maria Parham Physician Practices, LLC

  dba Maria Parham Primary Care

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1720364649
  NPD
• Granville Health System

  • Diagnostic Radiology Physician
  • Oxford, NC
  • NPI 1104683341
  NPD
• Granville Health System

  dba Granville Hospitalist Specialty Group

  • Hospitalist Physician
  • Oxford, NC
  • NPI 1629252986
  NPD
• Meritus Medical Center Inc

  dba Meritus Anesthesia Services

  • Anesthesiology Physician
  • Hagerstown, MD
  • NPI 1124886114
  NPD

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1063732055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 WILLOW GREEN DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275022507",
            "telephone_number": "240-338-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 WILLOW GREEN DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275022507",
            "telephone_number": "240-338-1418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210615803",
            "country_code": "US",
            "telephone_number": "410-787-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASSERES",
        "first_name": "BROOKTIETE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D97797",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2013-01617",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2013-01617",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7520999",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET FEDERAL SERVICES",
            "identifier": "1063732055",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063732055",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3652537",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS-MULTIPLAN",
            "identifier": "13305729",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH",
            "identifier": "1513788",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST, LLC",
            "identifier": "247602",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY NATIONAL - COVENTRY PPO",
            "identifier": "4468100",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-GREATWEST",
            "identifier": "9225005",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSMART",
            "identifier": "1063732055",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1063732055",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY OF THE CAROLINAS",
            "identifier": "1513788",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCTORS DIRECT",
            "identifier": "1063732055",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "1806P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CAROLINA CARE",
            "identifier": "FH1101395",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Apex, NC
• Providers in Apex, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.