Individual provider Active NPI

Brooke Eileen Decker, NP-C

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1063927580
Registry record updated Jun 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9312580 Issued in FL
Practice address
2985 Drew St
Clearwater, FL 33759-3012
Phone
(641) 425-5083
NPI assigned
Dec 6, 2017
Last updated
Jun 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9312580 FL Primary

Addresses

Primary practice location

2985 Drew St
Clearwater, FL 33759-3012

Mailing address

10335 Cross Creek Blvd Ste 20
Tampa, FL 33647-2764
Phone (813) 388-6838

Other practice location 1

10335 Cross Creek Blvd Ste 20
Tampa, FL 33647-2764
Phone (813) 388-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109002465 FL Practitioner - Nurse Practitioner 1759640212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Urgent Care, LLC.Group PAC ID 6103841051, 91 clinicians

Practice addresses (Care Compare)

2331 4TH St N
St Petersburg, FL 33704-2801
Phone (727) 914-8566

2645 S Florida Ave
Lakeland, FL 33803-3829
Phone (863) 606-6880

400 1St St N
Winter Haven
Winter Haven, FL 33881-4115
Phone (863) 299-2420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9312580FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Current Accepting new patients
Baycare Urgent Care, LLC Current Accepting new patients
Baycare Medical Group, Inc CurrentSince Jan 21, 2021 Accepting new patients
Baycare Urgent Care, LLC CurrentSince Jun 4, 2018 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 21, 2021 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2985 Drew St
Clearwater, FL 33759
Phone (727) 315-6775

2995 Drew St
Fl 3
Clearwater, FL 33759

4821 US Highway 19
Ste 5
New Port Richey, FL 34652
Phone (727) 851-9650

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

2331 4th St N
St Petersburg, FL 33704
Phone (727) 593-9848

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: brooke.guthartaprn@direct.mybaycare.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1063927580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10335 CROSS CREEK BLVD STE 20",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472764",
            "telephone_number": "813-388-6838",
            "fax_number": "813-388-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "641-425-5083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10335 Cross Creek Blvd Ste 20",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336472764",
            "country_code": "US",
            "telephone_number": "813-388-6838",
            "fax_number": "813-388-9526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECKER",
        "first_name": "BROOKE",
        "middle_name": "EILEEN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9312580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.